Lopez Andrade, Jose De Jesus
Lopez Andrade, Jose De Jesus is an sole proprietor health care provider with primary practice located at 14112 S Kingsley Dr , Gardena CA 90249-3018. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Lopez Andrade, Jose De Jesus can be contacted via phone (310) 217-7312.Contact Information
Primary practice address
14112 S Kingsley Dr
Gardena CA 90249-3018
Phone: (310) 217-7312
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor | 225C00000X | ||
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Behavioral Health & Social Service Providers / Psychologist | 103T00000X |
Profile Details
NPI number | 1881068450 |
---|---|
LBN Legal business name | Lopez Andrade, Jose De Jesus |
Credentials | PSY.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 19th, 2015 |
Last updated | Aug 21st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1881068450 | NPPES |
California | Other | 01536011 | MEDI-CAL |
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