Healthcare Provider Details

I. General information

NPI: 1891607305
Provider Name (Legal Business Name): JANETH LOPEZ LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 BUENA VISTA AVE W
SAN FRANCISCO CA
94117-4108
US

IV. Provider business mailing address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

V. Phone/Fax

Practice location:
  • Phone: 415-967-7058
  • Fax:
Mailing address:
  • Phone: 415-762-3700
  • Fax: 415-865-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN760886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: