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General NPI Number Information
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NPI Number | 1437036282
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Entity Type | Individual
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Provider Name | JENNIFER LOPEZ DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 7146 EDINGER AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3568
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Country | US
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Telephone | 714-377-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RIDGE CREST CIR
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City | PHILLIPS RANCH
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State | CA
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Zip | 91766-4914
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Country | US
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Telephone | 909-263-0638
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 308741
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License Number State | CA
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