Provider Demographics
NPI:1417828112
Name:LOPEZ, ISABELLA ROSE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ROSE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 DUNROBIN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3004
Mailing Address - Country:US
Mailing Address - Phone:562-250-2355
Mailing Address - Fax:
Practice Address - Street 1:12240 DUNROBIN AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3004
Practice Address - Country:US
Practice Address - Phone:562-250-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician