Individual
KRYSTAL RYAN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
418 E VANDERBILT WAY, SAN BERNARDINO, CA 92408-3552
(909) 373-1641
Mailing address
7254 FAIRFAX DR, SAN BERNARDINO, CA 92404-6321
(951) 833-3819
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA7266
CA
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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