Provider Demographics
NPI:1609377548
Name:LOPEZ, JULIA MARIE (MS, BCABA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2433
Mailing Address - Country:US
Mailing Address - Phone:323-426-6402
Mailing Address - Fax:
Practice Address - Street 1:208 OAK ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2433
Practice Address - Country:US
Practice Address - Phone:323-426-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-18-8668106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst