Provider Demographics
NPI:1053793224
Name:LOPEZ, ALEXANDER (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41934
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93384-1934
Mailing Address - Country:US
Mailing Address - Phone:661-900-0118
Mailing Address - Fax:
Practice Address - Street 1:1401 L ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4522
Practice Address - Country:US
Practice Address - Phone:661-868-6134
Practice Address - Fax:661-868-0841
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 91678106H00000X
CA124122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist