Active NPI
Jennifer Lopez
- Addiction (Substance Use Disorder) Counselor
- Los Angeles, CA
National Provider Identifier
1730061383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1419490525
- Practice address
- 12021 S Wilmington Blvd BLDG 18
Ste 301
Los Angeles, CA 90059 - Phone
- (424) 454-6081
- NPI assigned
- Jul 24, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1419490525 | CA | Primary |
Addresses
Primary practice location
12021 S Wilmington Blvd BLDG 18
Ste 301
Los Angeles, CA 90059
Mailing address
12021 S Wilmington Blvd BLDG 18
Ste 301
Los Angeles, CA 90059
Phone (424) 454-6081
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 |
|---|---|---|---|
| R1419490525 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1730061383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12021 S WILMINGTON BLVD BLDG 18",
"address_2": "STE 301",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90059",
"telephone_number": "424-454-6081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12021 S WILMINGTON BLVD BLDG 18",
"address_2": "STE 301",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90059",
"telephone_number": "424-454-6081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-24",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1419490525",
"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 Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.