Individual provider Active NPI

Sandra I Lopez-Baez, PHD

  • Clinical Psychologist
  • Charlottesville, VA
National Provider Identifier
1700819141
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004096 Issued in VA
Practice address
405 Emmet St S
Room 150
Charlottesville, VA 22903-2424
Phone
(434) 924-7034
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701003380 VA
Clinical Psychologist 103TC0700X 0810004096 VA Primary

Addresses

Primary practice location

405 Emmet St S
Room 150
Charlottesville, VA 22903-2424

Mailing address

405 Emmet St S
Room 150
Charlottesville, VA 22903-2424
Phone (434) 924-7034

Other identifiers 1

IdentifierTypeStateIssuer
12093636OtherVACAQH

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0701003380VAMDMental Health Counselor
0810004096VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1700819141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 EMMET ST S",
            "address_2": "ROOM 150",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032424",
            "telephone_number": "434-924-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 EMMET ST S",
            "address_2": "ROOM 150",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032424",
            "telephone_number": "434-924-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-BAEZ",
        "first_name": "SANDRA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701003380",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12093636",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.