Active NPI
Andrea Nicole Lopez, D.O.
- Student in an Organized Health Care Education/Training Program
- Loma Linda, CA
National Provider Identifier
1104576909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 11234 Anderson St BLDG Suitec
Loma Linda, CA 92350-1716 - Phone
- (909) 558-9532
- NPI assigned
- Mar 24, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 20A22120 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
11234 Anderson St BLDG Suitec
Loma Linda, CA 92350-1716
Mailing address
10935 Terra Vista Pkwy Apt 103
Rancho Cucamonga, CA 91730-6350
Phone (909) 377-9291
Other practice location 1
1800 N California St
Stockton, CA 95204-6019
Phone (209) 547-5716
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A22120 | CA | MD | Child & Adolescent Psychiatry Physician |
Interoperability endpoints
- tourouniversitymedicalgroup.andrealopez@155493.advancedmd-direct.com
- alopez1253395@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1104576909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10935 TERRA VISTA PKWY APT 103",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917306350",
"telephone_number": "909-377-9291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST BLDG SUITEC",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501716",
"telephone_number": "909-558-9532"
}
],
"practiceLocations": [
{
"address_1": "1800 N California St",
"address_purpose": "LOCATION",
"city": "Stockton",
"state": "CA",
"postal_code": "952046019",
"country_code": "US",
"telephone_number": "209-547-5716",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOPEZ",
"first_name": "ANDREA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-24",
"last_updated": "2025-05-05",
"certification_date": "2025-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "20A22120",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.