Individual provider · Type 1 NPI

Tracy Jo Lopez

Licensed Psychiatric Technician · Azusa, CA

NPI number 1699901751 Active

Practice location

23701 E East Fork Rd
Azusa, CA 91702-1477

Call (626) 910-1202 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000XPT 34770 (CA)

Licensed Psychiatric Technician: An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental dis…

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About NPI 1699901751

Tracy Jo Lopez's National Provider Identifier is 1699901751, issued on Jun 3, 2009. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in Azusa, CA. The record was last updated on Jun 3, 2009.