Laura Rebeca Mata Lopez, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95007152 Issued in CA

Practice address

325 Hospital Dr Ste 106
Glen Burnie, MD 21061-5806

Phone

(443) 430-2998

NPI assigned

Aug 23, 2017

Last updated

Apr 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Treatment CentersGroup PAC ID 1052784840, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Innovative Treatment Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Burnie, MD
  • NPI 1568175867
  Medicare reassignment Care Compare group
• Lifelong Medical Care

  • Family Medicine Physician
  • Rodeo, CA
  • NPI 1003289463
  NPD
• Lifelong Medical Care

  dba Over Sixty Health Center

  • Geriatric Medicine (Family Medicine) Physician
  • Berkeley, CA
  • NPI 1689670002
  NPD
• Yolo County Health and Human Services Agency

  • Community/Behavioral Health Agency
  • Davis, CA
  • NPI 1053443135
  NPD
• Yolo County Health and Human Services Agency

  • Community/Behavioral Health Agency
  • Woodland, CA
  • NPI 1144352220
  NPD
• Yolo County Health and Human Services Agency

  • Community/Behavioral Health Agency
  • Woodland, CA
  • NPI 1346446432
  NPD

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1871010793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 106",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "443-430-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 106",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "443-430-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA LOPEZ",
        "first_name": "LAURA",
        "middle_name": "REBECA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R251462",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95007152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Masek, NP-C
• Nziavake Masimasi, M.D.
• Cynthia Mason, LCPC
• Marylyn Mason, RN
• Justin Martin Massey, PSY.D.
• Denny Paul Mathew, MBBS
• Marsha Mathieu, MA
• Jamie Elizabeth Matlock, PA-C
• Tiffany Anne Matonak, PA-C
• Melissa Matthew

• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.

Verify at the official NPI Registry.