Individual
SANDRA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70124F
—
CA
01
—
ZZZ02040Z
MEDICARE GRP
CA
Enumeration date
05/25/2010
Last updated
06/14/2017
Update your record
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