Active NPI
Ivonne Lopez
- Behavior Technician
- Mecca, CA
National Provider Identifier
1053046706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 69165 Beachcomber Dr
Mecca, CA 92254-2617 - Phone
- (760) 771-7116
- NPI assigned
- Jul 18, 2022
- Last updated
- Jul 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
69165 Beachcomber Dr
Mecca, CA 92254-2617
Mailing address
69165 Beachcomber Dr
Mecca, CA 92254-2617
Phone (760) 771-7116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | CA | IEHP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658102400000",
"number": "1053046706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69165 BEACHCOMBER DR",
"city": "MECCA",
"state": "CA",
"postal_code": "922542617",
"telephone_number": "760-771-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69165 BEACHCOMBER DR",
"city": "MECCA",
"state": "CA",
"postal_code": "922542617",
"telephone_number": "760-771-7116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "IVONNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-18",
"last_updated": "2022-07-18",
"certification_date": "2022-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IEHP",
"identifier": "NA",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mecca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.