Active NPI
Walditrudez Lopez
- Assisted Living Facility
- Valencia, CA
National Provider Identifier
1316646342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 197601592
- Practice address
- 23844 Via Jacara
Valencia, CA 91355-2520 - Phone
- (818) 381-3449
- NPI assigned
- Feb 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 197601592 | CA | Primary |
Addresses
Primary practice location
23844 Via Jacara
Valencia, CA 91355-2520
Mailing address
15562 Sandra LN
Sylmar, CA 91342-3575
Phone (818) 381-3449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 197601592 | Medicaid | CA |
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 |
|---|---|---|---|
| 197601592 | CA | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677542400000",
"number": "1316646342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15562 SANDRA LN",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913423575",
"telephone_number": "818-381-3449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23844 VIA JACARA",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913552520",
"telephone_number": "818-381-3449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "WALDITRUDEZ",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-28",
"last_updated": "2023-02-28",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "CA",
"license": "197601592",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "197601592",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.