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Individual
MS. JACKELINE BEATRIZ LOPEZ
Active
Individual
MS. JACKELINE BEATRIZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86026975
CA
133VN1005X
Renal Nutrition Registered Dietitian
86026975
CA
363A00000X
Physician Assistant
Primary
62965
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/12/2017
Last updated
08/01/2023
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