Individual provider Active NPI

Marcus Gregory Lopez, LCSW

  • Clinical Social Worker
  • Oxnard, CA
National Provider Identifier
1104034768
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62683 Issued in CA
Practice address
2500 S C St Ste C
Oxnard, CA 93033-4573
Phone
(805) 385-9452
Fax
(805) 385-9401
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 62683 CA Primary

Addresses

Primary practice location

2500 S C St Ste C
Oxnard, CA 93033-4573

Mailing address

2500 S C St Ste C
Oxnard, CA 93033-4573
Phone (805) 385-9452

Other practice location 1

1068 E Main St Ste 230A
Ventura, CA 93001-5052
Phone (805) 765-2952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura Current Accepting new patients

Locations

1911 Williams Dr
Ste 200
Oxnard, CA 93036
Phone (805) 981-4221

72 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 371-9988

800 S Victoria Ave
#L4640
Ventura, CA 93009

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1104034768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S C ST STE C",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930334573",
            "telephone_number": "805-385-9452",
            "fax_number": "805-985-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S C ST STE C",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930334573",
            "telephone_number": "805-385-9452",
            "fax_number": "805-385-9401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 E Main St Ste 230A",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930015052",
            "country_code": "US",
            "telephone_number": "805-765-2952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARCUS",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "62683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.