Active NPI
Juan Jose Lopez
- Behavior Analyst
- San Diego, CA
National Provider Identifier
1265085690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1700383825
- Practice address
- 11665 Avena PL Ste 204
San Diego, CA 92128-2428 - Phone
- (858) 200-8480
- NPI assigned
- Jul 24, 2019
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1700383825 | CA | Primary |
Addresses
Primary practice location
11665 Avena PL Ste 204
San Diego, CA 92128-2428
Mailing address
3405 Roosevelt St
Carlsbad, CA 92008-5037
Phone (760) 845-0782
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1700383825 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1265085690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3405 ROOSEVELT ST",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920085037",
"telephone_number": "760-845-0782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11665 AVENA PL STE 204",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282428",
"telephone_number": "858-200-8480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JUAN",
"middle_name": "JOSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-24",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1700383825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.