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NPI Code Detail

MEDICARE: JEANNETTE LOPEZ AMFT

MEDICARE: JEANNETTE LOPEZ AMFT
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
1106H00000XMarriage & Family Therapist122160CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11629809579OTHERCAHQ
21407660251OTHERCASFV
31871324046OTHERCAAV

General Provider Information

NPI Number : 1275119885
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNETTE LOPEZ AMFT
Provider Business Mailing Address
First Line : 435 YALE AVE
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4340
Country : US
Telephone Number : 909-417-1021
Fax Number :
Provider Business Practice Location Address
First Line : 435 YALE AVE
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4340
Country : US
Telephone Number : 909-575-4217
Fax Number : 909-621-0614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 03/13/2026

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Directions to “ JEANNETTE LOPEZ AMFT” Practice Location

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