Mayra Gricel Lopez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

91999 Issued in CA

Practice address

1989 Vicente Dr
San Luis Obispo, CA 93405-6863

Phone

(805) 781-1354

NPI assigned

Jan 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
  • NPI 1932563053
  NPD (past)

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1386180628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 VICENTE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056863",
            "telephone_number": "805-781-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 VICENTE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056863",
            "telephone_number": "805-781-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MAYRA",
        "middle_name": "GRICEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "73702",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandra Lopez
• Alma Roxanna Lopez
• Gwendolyn Lopez
• Jennifer Marie Lopez
• Maria Josefa Lopez
• Ricardo Jose Lopez
• Nir Yehuda Lorant, M.D.
• Rose Lorenzo-Maxwell
• Allison M Lorne, CNM
• Laurence H Lotz, MD

• Clinical Social Worker in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.