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NPI Code Detail

MEDICARE: ROSA ISELA CERVANTES LOPEZ

MEDICARE: ROSA ISELA CERVANTES LOPEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1053242677
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA ISELA CERVANTES LOPEZ
Provider Business Mailing Address
First Line : 3133 SUNFLOWER DR
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-6357
Country : US
Telephone Number : 925-384-7916
Fax Number :
Provider Business Practice Location Address
First Line : 2570 48TH ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1541
Country : US
Telephone Number : 916-734-2145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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Directions to “ ROSA ISELA CERVANTES LOPEZ ” Practice Location

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