Individual provider Active NPI

Noe Lopez, FNP

  • Family Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1962936930
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013248 Issued in CA
Practice address
16839 Ramona Ave Ste 401
Fontana, CA 92336-2014
Phone
(909) 429-2864
NPI assigned
Apr 17, 2017
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013248 CA Primary
Diabetes Educator Registered Nurse 163WD0400X 610082 CA

Addresses

Primary practice location

16839 Ramona Ave Ste 401
Fontana, CA 92336-2014

Mailing address

16839 Ramona Ave Ste 401
Fontana, CA 92336-2014
Phone (909) 429-2864

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220422002011 CA Practitioner - Nurse Practitioner 3274920160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cucamonga Valley Medical Group IncGroup PAC ID 6709899883, 24 clinicians

Practice addresses (Care Compare)

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242
Phone (909) 429-2864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013248CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 24, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cucamonga Valley Medical Group, Inc. CurrentSince Jan 15, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 24, 2025 Accepting new patients

Locations

16465 Sierra Lakes Pkwy
Ste 300
Fontana, CA 92336
Phone (909) 429-2864

16839 Ramona Ave
Ste 401
Fontana, CA 92336
Phone (909) 429-2864

17264 Foothill Blvd
Ste A
Fontana, CA 92335
Phone (909) 428-3900

17296 Slover Ave
Fontana, CA 92337
Phone (909) 609-3000

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

1310 San Bernardino Rd
Ste 105
Upland, CA 91786
Phone (909) 429-2864

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1962936930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16839 RAMONA AVE STE 401",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362014",
            "telephone_number": "909-429-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16839 RAMONA AVE STE 401",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362014",
            "telephone_number": "909-429-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "NOE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2025-05-27",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013248",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "610082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.