Crystal Lynn Lopez, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

209814 Issued in CA

Practice address

250 N See Vee Lane
Bishop, CA 93514-8130

Phone

(760) 873-8461

Fax

(760) 873-3935

NPI assigned

Sep 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crystal Lynn List Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1871077214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SEE VEE LANE",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148130",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N SEE VEE LANE",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148130",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "209814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THP11576F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "LIST",
            "middle_name": "LYNN",
            "credential": "LVN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rodolfo Ramon Leyva, DDS
• Ezra Quinn Licciardi, PARAMEDIC
• David Lichtenfeld, MD
• Doris Lin, M.D.
• Aurelio Lopez, RBT
• Bo Nasmyth Loy, M.D.
• Robert Charles Lukesh, MD
• Sarah Malloy, FNP-BC
• Kira Maltone
• Cory Shane Mann

• Licensed Vocational Nurse in Bishop, CA
• Providers in Bishop, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.