Active NPI
Gustavo Lopez
- Addiction (Substance Use Disorder) Counselor
- Truckee, CA
National Provider Identifier
1194938480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 10015 Palisades Dr Ste 1
Truckee, CA 96161-1941 - Phone
- (530) 587-8194
- Fax
- (530) 587-5617
- NPI assigned
- May 7, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
10015 Palisades Dr Ste 1
Truckee, CA 96161-1941
Mailing address
PO Box 1344
Truckee, CA 96160-1344
Phone (530) 587-8194
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granite Wellness Centers | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Truckee Service Center
- Community/Behavioral Health Agency
- Truckee, CA
- NPI 1376727693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194938480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1344",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961601344",
"telephone_number": "530-587-8194",
"fax_number": "530-587-5617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10015 PALISADES DR STE 1",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961611941",
"telephone_number": "530-587-8194",
"fax_number": "530-587-5617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GUSTAVO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.