Individual
RUTH MARIBEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
42150 JACKSON ST, INDIO, CA 92203-9780
(442) 300-3200
Mailing address
84116 OLONA CT, INDIO, CA 92203-2967
(720) 224-8249
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
53490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U9605340001
CIGNA
CA
Enumeration date
08/20/2025
Last updated
08/20/2025
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