Provider Demographics
NPI:1770376212
Name:LOPEZ, ROSA KAREN (PEER SUPPORT SPECIAL)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:KAREN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PEER SUPPORT SPECIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8510 NOELINE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-7438
Mailing Address - Country:US
Mailing Address - Phone:619-301-3386
Mailing Address - Fax:619-301-3386
Practice Address - Street 1:286 EUCLID AVE STE 206
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3612
Practice Address - Country:US
Practice Address - Phone:619-301-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist