Provider Demographics
NPI:1811878176
Name:LOPEZ, BERENICE
Entity type:Individual
Prefix:
First Name:BERENICE
Middle Name:
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 1:25100 EARHART RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5257
Mailing Address - Country:US
Mailing Address - Phone:949-581-1370
Mailing Address - Fax:949-581-8520
Practice Address - Street 1:25100 EARHART RD
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5257
Practice Address - Country:US
Practice Address - Phone:949-581-1370
Practice Address - Fax:949-581-8520
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool