Anna Ginna Lasala-Lopez

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

27201 Issued in CA

Practice address

265 S Anita Dr Ste 201
Orange, CA 92868-3346

Phone

(714) 410-3505

Fax

(714) 410-3529

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Orange, CA
  • NPI 1376146050
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1356911549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25402 PACIFICA AVE",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926913854",
            "telephone_number": "949-238-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 S ANITA DR STE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683346",
            "telephone_number": "714-410-3505",
            "fax_number": "714-410-3529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25402 Pacifica Ave",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926913854",
            "country_code": "US",
            "telephone_number": "949-238-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASALA-LOPEZ",
        "first_name": "ANNA",
        "middle_name": "GINNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "27201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenna Larsen
• Eva Dolores Larson, PA
• Isaac Larson
• Michael Alexander B Larson
• Rose Ann Larson
• Emily Whitney Lashchuk
• Bailey Noel Lassiter
• Brian A Lassiter, DDS
• Katherine Charles Lasure
• Justin Jeffrey Lat

• Licensed Psychiatric Technician in Orange, CA
• Providers in Orange, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.