Jessie Lopez, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301013521 Issued in MI

Practice address

310 E Oak St
Kingman, AZ 86401-5840

Phone

(928) 377-1963

NPI assigned

Mar 6, 2009

Last updated

Mar 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1164662961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 JOHN WAYNE DR",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093189",
            "telephone_number": "928-377-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E OAK ST",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864015840",
            "telephone_number": "928-377-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhao Liu, MD
• Rachel L Logan, DO
• Brian J Long, BA
• Jessica Long, FNP-C
• Lorraine Rachelle Long
• Joshua Ryan Lopez, DPT
• Low Cost Medical Suppiies and Service
• Mary Lowell, M.S. C.C.C. SLP
• Jason W Lowry, D.D.S.
• Charles Joseaph Lucero, DDS

• Psychologist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.