Individual provider Active NPI

Lora Haftopulos, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1245922053
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95024148 Issued in CA
Practice address
10459 Mountain View Ave
Loma Linda, CA 92354-2033
Phone
(909) 799-5400
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95024148 CA Primary

Addresses

Primary practice location

10459 Mountain View Ave
Loma Linda, CA 92354-2033

Mailing address

10459 Mountain View Ave Ste E
Loma Linda, CA 92354-2033

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
95024148CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1245922053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10459 MOUNTAIN VIEW AVE STE E",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10459 MOUNTAIN VIEW AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542033",
            "telephone_number": "909-799-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFTOPULOS",
        "first_name": "LORA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.