Healthcare Provider Details

I. General information

NPI: 1609714195
Provider Name (Legal Business Name): CHRISTINA STEPHANIE LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 FOLSOM ST
SAN FRANCISCO CA
94110-2010
US

IV. Provider business mailing address

2355 FOLSOM ST
SAN FRANCISCO CA
94110-2010
US

V. Phone/Fax

Practice location:
  • Phone: 415-244-2981
  • Fax:
Mailing address:
  • Phone: 415-695-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: