Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miguel Ezequiel Lopez

Individual provider Marriage & Family Therapist · NPI 1104413640

Miguel Ezequiel Lopez is a Marriage and Family Therapist in Modesto, California. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 577924
Modesto, CA 95357-7924
Phone: (094) 123-4252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 155022 (CA)

Record details

NPI number1104413640
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 30, 2020
Last updated in NPPESJune 26, 2025
Certification dateJune 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Modesto