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General NPI Number Information
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NPI Number | 1629977434
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Entity Type | Individual
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Provider Name | CHRISTIAN E LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 494 BLOSSOM WAY
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City | CHERRYLAND
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State | CA
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Zip | 94541-1948
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Country | US
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Telephone | 510-582-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 125 W 9TH ST UNIT 531
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City | TRACY
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State | CA
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Zip | 95378-3023
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Country | US
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Telephone |
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 00814321
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License Number State | CA
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