Active NPI
Gisela C Lopez
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1619508348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 147053
- Practice address
- 840 N Avenue 66
Los Angeles, CA 90042-1508 - Phone
- (626) 395-7100
- NPI assigned
- Jan 31, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 117715 | CA | |
| Marriage & Family Therapist | 106H00000X | 147053 | CA | Primary |
Addresses
Primary practice location
840 N Avenue 66
Los Angeles, CA 90042-1508
Mailing address
840 N Avenue 66
Los Angeles, CA 90042-1508
Phone (626) 395-7100
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 |
|---|---|---|---|
| 117715 | CA | MD | Marriage & Family Therapist |
| 147053 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1619508348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421508",
"telephone_number": "626-395-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421508",
"telephone_number": "626-395-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GISELA",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "117715",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "147053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.