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NPI Code Detail

MEDICARE: SHANA LOPEZ

MEDICARE: SHANA 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
1106H00000XMarriage & Family Therapist52844CA

General Provider Information

NPI Number : 1902765969
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANA LOPEZ
Provider Business Mailing Address
First Line : 9390 BASE LINE RD
Second Line :
City : ALTA LOMA
State : CA
Zip : 91701-5839
Country : US
Telephone Number : 909-484-5151
Fax Number :
Provider Business Practice Location Address
First Line : 9390 BASE LINE RD
Second Line :
City : ALTA LOMA
State : CA
Zip : 91701-5839
Country : US
Telephone Number : 909-484-5151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ SHANA LOPEZ ” Practice Location

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