Shantel Fernandez Lopez, BA, MA, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1205 Issued in HI

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(808) 433-2460

Fax

(808) 433-1558

NPI assigned

Sep 27, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Arts, Doctor of Philosophy

State licenses

Practice roles

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

• Parent Child Therapy Center

  • Clinical Child & Adolescent Psychologist
  • Kapolei, HI
  • NPI 1629640859
  NPD Authorized official

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1740599653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92-1357 Punawainui St",
            "address_purpose": "LOCATION",
            "city": "Kapolei",
            "state": "HI",
            "postal_code": "967072831",
            "country_code": "US",
            "telephone_number": "808-681-2309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ LOPEZ",
        "first_name": "SHANTEL",
        "name_prefix": "Dr.",
        "credential": "BA, MA, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "1205",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "HI",
            "license": "1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Fa, M.D.
• Salvatore Carlo Falisi, MD
• John Michael Reyes Faria, PHARMD
• Omar Faruque, D.O.
• Leonard Jay Ferguson, PA-C
• Roberto C Fernandez, DO
• Justin Jay Fienhold, LCSW
• Eamon L Filan, D.O.
• Jasmin Isabel Filpo, O.D.
• Thomas Michael Finstein, DO

• Clinical Child & Adolescent Psychologist in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Clinical Child & Adolescent Psychologist in Hawaii

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

Verify at the official NPI Registry.