Individual provider Active NPI

Nestor L Lopez-Duran, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Ann Arbor, MI
National Provider Identifier
1770856221
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
6301014368 Issued in MI
Practice address
530 Church St Ste 1465
Ann Arbor, MI 48109-1043
Phone
(734) 647-1051
NPI assigned
Feb 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 6301014368 MI Primary

Addresses

Primary practice location

530 Church St Ste 1465
Ann Arbor, MI 48109-1043

Mailing address

530 Church St Ste 1465
Ann Arbor, MI 48109-1043
Phone (734) 647-1051

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
6301014368MIMDClinical Child & Adolescent Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1770856221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CHURCH ST STE 1465",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091043",
            "telephone_number": "734-647-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CHURCH ST STE 1465",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091043",
            "telephone_number": "734-647-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-DURAN",
        "first_name": "NESTOR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301014368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.