Leezett Andrea Lopez, RN, BSN, PHN, CCRN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001634 Issued in CA

Practice address

9961 Sierra Ave
Fontana, CA 92335-6720

Phone

(833) 574-2273

NPI assigned

Jul 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JP Anesthesia IncGroup PAC ID 1759750193, 14 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group NPD
• JP Anesthesia Inc

  • Certified Registered Nurse Anesthetist
  • Fontana, CA
  • NPI 1609590926
  Medicare reassignment Care Compare group
• Marquee Anesthesia Consultants Inc

  • Certified Registered Nurse Anesthetist
  • Redlands, CA
  • NPI 1760942619

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1235650672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N State St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335000",
            "country_code": "US",
            "telephone_number": "232-409-3929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LEEZETT",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "RN, BSN, PHN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "837949",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabriel Edward Lopez, MD
• Jackeline Beatriz Lopez, PA-C, RDN
• Jasmine Rose Lopez
• John Lopez
• Karla Taborga Lopez, FNP
• Miguel Angel Lopez, C.R.N.A.
• Nicole V Lopez, M.S.
• Noe Lopez, FNP
• Raymond Lopez
• Rebecca Marie Lopez, MD

• Certified Registered Nurse Anesthetist in Fontana, CA
• Providers in Fontana, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.