Active NPI
Marco Antonio Lopez
- Mental Health Counselor
- Ontario, CA
National Provider Identifier
1699081968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW85389
- Practice address
- 2940 Inland Empire Blvd
Ontario, CA 91764 - Phone
- (909) 458-1350
- Fax
- (909) 579-8149
- NPI assigned
- Aug 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW85389 | CA | Primary |
Addresses
Primary practice location
2940 Inland Empire Blvd
Ontario, CA 91764
Mailing address
541 N San Jacinto St
Hemet, CA 92543-3107
Phone (951) 791-3687
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 |
|---|---|---|---|
| ASW85389 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1699081968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 N SAN JACINTO ST",
"city": "HEMET",
"state": "CA",
"postal_code": "925433107",
"telephone_number": "951-791-3687",
"fax_number": "951-791-3689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 INLAND EMPIRE BLVD",
"city": "ONTARIO",
"state": "CA",
"postal_code": "91764",
"telephone_number": "909-458-1350",
"fax_number": "909-579-8149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MARCO",
"middle_name": "ANTONIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-25",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW85389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.