Individual provider Active NPI

Leticia Lopez

  • Primary Care Nurse Practitioner
  • San Fernando, CA
National Provider Identifier
1831547249
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95004130 Issued in CA
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

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240531002557 CA Practitioner - Nurse Practitioner 0749622017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health CorporationGroup PAC ID 3173517323, 77 clinicians

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

LicenseStateTypeSpecialty
95004130CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Valley Health Corporation Current Accepting new patients
Northeast Valley Health Corporation CurrentSince Apr 3, 2024 Accepting new patients
Northeast Valley Health Corporation CurrentSince Apr 3, 2024 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.