Job Portillo Lopez, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9223 Issued in CA

Practice address

81767 Dr Carreon Blvd Ste 102
Indio, CA 92201-5598

Phone

(760) 863-5355

Fax

(760) 863-5885

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

Yes

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 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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

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 and National Provider Directory roles.

• Desert Family Care

  • Family Nurse Practitioner
  • Indio, CA
  • NPI 1023215308
  NPD (past) Authorized official
• Lifschutz Medical Group a Professional Corporation

  • Family Medicine Physician
  • Indio, CA
  • NPI 1043060387
  NPD
• Clinica Medica del Valle, Inc.

  • Pediatric Surgery Physician
  • Coachella, CA
  • NPI 1790921641
  NPD (past)
• Stephen B. Lee Medical Corporation at Coachella

  dba Clinica Medica Del Valle, Inc.

  • Family Medicine Physician
  • Coachella, CA
  • NPI 1700026549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1871565796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80834 GENTLE BREEZE DR",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922018478",
            "telephone_number": "760-578-5612",
            "fax_number": "760-863-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81767 DR CARREON BLVD STE 102",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015598",
            "telephone_number": "760-863-5355",
            "fax_number": "760-863-5885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57370 29 Palms Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922842900",
            "country_code": "US",
            "telephone_number": "760-398-0606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45677 Oasis St",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922014564",
            "country_code": "US",
            "telephone_number": "760-398-0606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "52565 Cesar Chavez St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Coachella",
            "state": "CA",
            "postal_code": "922361534",
            "country_code": "US",
            "telephone_number": "760-398-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOB",
        "middle_name": "PORTILLO",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF9223  RN643640",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "9223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Lopez
• Esther Angie Lopez, RN
• Giselle Marissa Lopez
• Ichiro Lopez
• Jennifer A Lopez
• Jody Danielle Lopez
• Mariah Mia Lopez
• Maya Lopez
• Michael Joel Lopez, CADC I
• Miguel Lopez

• Family Nurse Practitioner in Indio, CA
• Providers in Indio, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.