Individual provider Active NPI

Krystal Ryan Lopez

  • Occupational Therapy Assistant
  • San Bernardino, CA
National Provider Identifier
1154297364
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA7266 Issued in CA
Practice address
418 E Vanderbilt Way
San Bernardino, CA 92408-3552
Phone
(909) 373-1641
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA7266 CA Primary

Addresses

Primary practice location

418 E Vanderbilt Way
San Bernardino, CA 92408-3552

Mailing address

7254 Fairfax Dr
San Bernardino, CA 92404-6321
Phone (951) 833-3819

Other names 1

  • Krystal Ryan Beadel Former name

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

State licenses

LicenseStateTypeSpecialty
OTA7266CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Therapy Services CurrentSince Oct 21, 2025 Accepting new patients
Horizon Therapy Services PastSince Oct 21, 2025 Accepting new patients

Locations

418 E Vanderbilt Way
San Bernardino, CA 92408
Phone (909) 373-1641

Organizations & group practices 2

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": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1154297364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7254 FAIRFAX DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924046321",
            "telephone_number": "951-833-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083552",
            "telephone_number": "909-373-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KRYSTAL",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA7266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "BEADEL",
            "middle_name": "RYAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.