Provider Demographics
NPI:1184228728
Name:LOPEZ, NICOLE CHRISTINE (ATC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13171 SUMMIT CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2115
Mailing Address - Country:US
Mailing Address - Phone:909-706-7399
Mailing Address - Fax:
Practice Address - Street 1:13171 SUMMIT CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2115
Practice Address - Country:US
Practice Address - Phone:909-706-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty