Individual provider Active NPI

Daniel Lopez

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1033698188
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
107710 Issued in CA
Practice address
1360 E Anaheim St Ste 205
Long Beach, CA 90813-5517
Phone
(562) 218-9530
NPI assigned
Aug 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Marriage & Family Therapist 106H00000X 107710 CA Primary

Addresses

Primary practice location

1360 E Anaheim St Ste 205
Long Beach, CA 90813-5517

Mailing address

1360 E Anaheim St Ste 205
Long Beach, CA 90813-5517
Phone (562) 218-9530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 10, 2024 through Jan 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107710CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Asian American Drug Abuse Program, Inc PastSince Aug 28, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1033698188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E ANAHEIM ST STE 205",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908135517",
            "telephone_number": "562-218-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E ANAHEIM ST STE 205",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908135517",
            "telephone_number": "562-218-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "107710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.