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General NPI Number Information
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NPI Number | 1881071215
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Entity Type | Individual
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Provider Name | ASHLEY EDEN LOPEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 11234 ANDERSON ST
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City | LOMA LINDA
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State | CA
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Zip | 92350-1716
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Country | US
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Telephone | 909-558-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 7717 CHURCH AVE SPC 2
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City | HIGHLAND
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State | CA
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Zip | 92346-4313
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Country | US
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Telephone | 303-408-6000
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95000318
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License Number State | CA
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