Healthcare Provider Details

I. General information

NPI: 1346158631
Provider Name (Legal Business Name): CATHERINE ROSE LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 CAMINO RAMON STE 200
SAN RAMON CA
94583-9137
US

IV. Provider business mailing address

1212 MARYLAND ST APT 402
SAN FRANCISCO CA
94107-4394
US

V. Phone/Fax

Practice location:
  • Phone: 925-678-4010
  • Fax:
Mailing address:
  • Phone: 415-416-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: