| Doctor Name: | MARINA LOPEZ |
| NPI Number: | 1205070216 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2021 Sutter Ave San Pablo, CA - 948064490 |
| Business Phone Number: | 5102320874 |
| Business Fax Number: | |
| Mailing Address: | 2021 Sutter Ave, SAN PABLO |
| State: | CA |
| Postal Code: | 948064490 |
| Phone Number: | 5102320874 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2009 |
| NPI Last Update Date: | 04/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |