Jacob Lopez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50785 Issued in CA

Practice address

31360 Via Colinas Ste 104
Westlake Village, CA 91362-6821

Phone

(805) 492-1500

NPI assigned

Jan 14, 2022

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1619628294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10966 HENDERSON PL",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041830",
            "telephone_number": "805-795-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31360 VIA COLINAS STE 104",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913626821",
            "telephone_number": "805-492-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JACOB",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fang-Yu Liu, MD
• Linda Liu, PA
• Thomas F Locke, PHD
• Linda Loomis, MFT
• Ana Lopez, BA
• Julissa Lopez, PTA
• Keren Lopez
• Zaira Lopez, BA, RBT
• Cheyenne Lorentz
• Los Robles Hospice, Inc.

• Physical Therapy Assistant in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.