Individual provider Active NPI

Giovanni Lopez-Huerta Sr., AMFT

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1487326880
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127380 Issued in CA
Practice address
17053 Foothill Blvd BLDG 2
Fontana, CA 92335-3574
Phone
(909) 347-1356
NPI assigned
Oct 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 306406 CA
Marriage & Family Therapist 106H00000X 127380 CA Primary

Addresses

Primary practice location

17053 Foothill Blvd BLDG 2
Fontana, CA 92335-3574

Mailing address

17053 Foothill Blvd BLDG 2
Fontana, CA 92335-3574
Phone (909) 347-1356

Other names 1

  • Mr. Giovanni Lopez Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108002933 CA Practitioner - Marriage and Family Therapist 2668900341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127380CAMDClinical Social Worker
306406CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 19, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 19, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1487326880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17053 FOOTHILL BLVD BLDG 2",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353574",
            "telephone_number": "909-347-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17053 FOOTHILL BLVD BLDG 2",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353574",
            "telephone_number": "909-347-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-HUERTA",
        "first_name": "GIOVANNI",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-04",
        "last_updated": "2024-12-30",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "306406",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GIOVANNI",
            "last_name": "LOPEZ",
            "prefix": "MR.",
            "credential": "AMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.