Healthcare Provider Details

I. General information

NPI: 1487380234
Provider Name (Legal Business Name): DANIELA HURTADO-LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1849 N HARVARD BLVD APT 6
LOS ANGELES CA
90027-3638
US

IV. Provider business mailing address

1849 N HARVARD BLVD APT 6
LOS ANGELES CA
90027-3638
US

V. Phone/Fax

Practice location:
  • Phone: 909-365-9192
  • Fax:
Mailing address:
  • Phone: 909-365-9192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: