Active NPI
Jose Lopez, FNP-C
- Family Nurse Practitioner
- Redlands, CA
National Provider Identifier
1114535044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95014938
- Practice address
- 2 W Fern Ave
Redlands, CA 92373-5916 - Phone
- (909) 793-3311
- NPI assigned
- Jul 16, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95014938 | CA | Primary |
Addresses
Primary practice location
2 W Fern Ave
Redlands, CA 92373-5916
Mailing address
PO Box 10069
San Bernardino, CA 92423-0069
Phone (093) 354-1889
Other practice location 1
350 Terracina Blvd
Redlands, CA 92373-4850
Phone (909) 335-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Health Plan of California, Inc. | Current | Accepting new patients | |
| Universal Care | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
Interoperability endpoints
- jlopez13049@direct-prd.molinahealthcare.com
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Diamond Bar, CA
- NPI 1386714772
-
dba Molina Medical Centers
- Health Maintenance Organization
- Long Beach, CA
- NPI 1194811760
-
- Pediatrics Physician
- Long Beach, CA
- NPI 1376632877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1114535044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10069",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924230069",
"telephone_number": "093-354-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W FERN AVE",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735916",
"telephone_number": "909-793-3311"
}
],
"practiceLocations": [
{
"address_1": "350 Terracina Blvd",
"address_purpose": "LOCATION",
"city": "Redlands",
"state": "CA",
"postal_code": "923734850",
"country_code": "US",
"telephone_number": "909-335-5500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOPEZ",
"first_name": "JOSE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-16",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95014938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.