Individual
AMANDA NICOLE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3950 GRAND AVE STE A, CHINO, CA 91710-5492
(909) 664-0057
Mailing address
16201 PORTER AVE, RIVERSIDE, CA 92504-6006
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
36223
CA
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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