Individual provider Active NPI

M Guadalupe M Lopez, LVN

  • Licensed Vocational Nurse
  • Fresno, CA
National Provider Identifier
1780267252
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
257963 Issued in CA
Practice address
4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604
Phone
(559) 600-2382
NPI assigned
May 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 257963 CA Primary

Addresses

Primary practice location

4411 E Kings Canyon Rd # 319
Fresno, CA 93702-3604

Mailing address

3433 W Shaw Ave Ste 102
Fresno, CA 93711-3229
Phone (559) 558-4051

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

LicenseStateTypeSpecialty
257963CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1780267252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 W SHAW AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113229",
            "telephone_number": "559-558-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E KINGS CANYON RD # 319",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "M GUADALUPE",
        "middle_name": "M",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "257963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.