Kimberly Belen Lopez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW112171 Issued in CA

Practice address

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601

Phone

(760) 924-1740

NPI assigned

Aug 23, 2021

Last updated

Oct 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Mono

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mammoth Lakes, CA
  • NPI 1538266911
  NPD
• Mono County Behavioral Health

  • Community/Behavioral Health Agency
  • Mammoth Lakes, CA
  • NPI 1861050643
  NPD

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1700553302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2619",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462619",
            "telephone_number": "760-924-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466601",
            "telephone_number": "760-924-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KIMBERLY",
        "middle_name": "BELEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW112171",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Seung-Sup Lee
• Jennifer Kei Kehaulani Leialoha Lane, MSTOM, HHP, L. AC.
• Han Li, LCSW
• Sara J Lokan, M.P.T.
• Kathryn Lonsdale, DPT
• Rodrigo Lucero Castelan
• Sandra Jean Lund
• Gabriela Macmillan
• Mammoth Lakes Fire Protection District
• Mammoth Lakes Orthopedics Associates

• Clinical Social Worker in Mammoth Lakes, CA
• Providers in Mammoth Lakes, 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 26, 2023; 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.