MEDICARE: SIOMARA LOPEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst		CA

General Provider Information

NPI Number	:	1750230850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIOMARA LOPEZ

Provider Business Mailing Address
First Line	:	3045 S ARCHIBALD AVE
Second Line	:	STE H-1043
City	:	ONTARIO
State	:	CA
Zip	:	91761
Country	:	US
Telephone Number	:	951-337-0954
Fax Number	:

Provider Business Practice Location Address
First Line	:	3045 S ARCHIBALD AVE
Second Line	:	STE H-1043
City	:	ONTARIO
State	:	CA
Zip	:	91761
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	03/09/2026

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Directions to “ SIOMARA LOPEZ ” Practice Location

Language	Start Address	Practice Location

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