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General NPI Number Information
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NPI Number | 1235456526
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Entity Type | Individual
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Provider Name | TESLA YAMILETH LOPEZ-ORTEGA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 275 HOSPITAL PKWY
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City | SAN JOSE
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State | CA
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Zip | 95119-1106
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Country | US
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Telephone | 408-506-9775
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 MICHAEL BO LN
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City | GILROY
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State | CA
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Zip | 95020-2717
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Country | US
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Telephone | 408-506-9775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95030414
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 758597
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License Number State | CA
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