Active NPI
Edna M Osorio Lopez
- Rehabilitation Psychologist
- Ontario, CA
National Provider Identifier
1346885878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- OTA3935
- Practice address
- 926 W Philadelphia St Unit 84
Ontario, CA 91762-6240 - Phone
- (909) 238-5267
- NPI assigned
- Nov 7, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Psychologist | 103TR0400X | OTA3935 | CA | Primary |
Addresses
Primary practice location
926 W Philadelphia St Unit 84
Ontario, CA 91762-6240
Mailing address
926 W Philadelphia St Unit 84
Ontario, CA 91762-6240
Phone (909) 238-5267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | CA | NA |
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 |
|---|---|---|---|
| OTA3935 | CA | MD | Rehabilitation Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573084800000",
"number": "1346885878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "926 W PHILADELPHIA ST UNIT 84",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917626240",
"telephone_number": "909-238-5267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "926 W PHILADELPHIA ST UNIT 84",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917626240",
"telephone_number": "909-238-5267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSORIO LOPEZ",
"first_name": "EDNA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-07",
"last_updated": "2019-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "CA",
"license": "OTA3935",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.