Active NPI
Leticia Lopez
- Primary Care Nurse Practitioner
- San Fernando, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 95004130
- Practice address
- 1172 N Maclay Ave
San Fernando, CA 91340-1328 - Phone
- (818) 898-1388
- Fax
- (818) 270-9590
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 95004130 | CA | Primary |
Addresses
Primary practice location
1172 N Maclay Ave
San Fernando, CA 91340-1328
Mailing address
1172 N Maclay Ave
San Fernando, CA 91340-1328
Phone (818) 898-1388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531
13356 Eldridge Ave
Sylmar, CA 91342-3200
Phone (818) 362-6182
14624 Sherman Way
FL 6
Van Nuys, CA 91405-2241
Phone (818) 988-6335
1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086
7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570
7843 Lankershim Blvd
North Hollywood, CA 91605-2523
Phone (818) 826-5555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95004130 | CA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| Northeast Valley Health Corporation | Current | Accepting new patients |
Locations
7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656
12756 Van Nuys Blvd
Pacoima, CA 91331
Phone (818) 896-0531
1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086
1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- leticia.lopez.p1@direct.nevhc.nextgenshare.com
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Van Nuys, CA
- NPI 1629079009
-
- Federally Qualified Health Center (FQHC)
- Santa Clarita, CA
- NPI 1548960834
-
- Community Health Clinic/Center
- Valencia, CA
- NPI 1730180118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464134400000",
"number": "1831547249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1172 N MACLAY AVE",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913401328",
"telephone_number": "818-898-1388",
"fax_number": "818-270-9590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1172 N MACLAY AVE",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913401328",
"telephone_number": "818-898-1388",
"fax_number": "818-270-9590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "LETICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-25",
"last_updated": "2016-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "95004130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.