Individual
CRYSTAL LYNN LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
250 N SEE VEE LANE, BISHOP, CA 93514-8130
(760) 873-8461
(760) 873-3935
Mailing address
250 N SEE VEE LANE, BISHOP, CA 93514-8130
(760) 873-8461
(760) 873-3935
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
209814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THP11576F
—
CA
Enumeration date
09/21/2018
Last updated
09/21/2018
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