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NPI Code Detail

MEDICARE: ALEXIS LOPEZ

MEDICARE: ALEXIS 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
1106S00000XBehavior TechnicianCA
2225X00000XOccupational Therapist23231CA

General Provider Information

NPI Number : 1760982714
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS LOPEZ
Provider Business Mailing Address
First Line : 8282 WHITE OAK AVE STE 107
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-7681
Country : US
Telephone Number : 909-586-0509
Fax Number : 909-929-0805
Provider Business Practice Location Address
First Line : 8282 WHITE OAK AVE STE 107
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-7681
Country : US
Telephone Number : 909-586-0509
Fax Number : 909-929-0805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2018
Last Update Date : 02/07/2022

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Directions to “ ALEXIS LOPEZ ” Practice Location

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