Provider Demographics
NPI:1477934701
Name:LOPEZ, ALEJANDRA (LVN)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12459 RALSTON AVE # C
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4693
Mailing Address - Country:US
Mailing Address - Phone:661-390-0507
Mailing Address - Fax:
Practice Address - Street 1:12459 RALSTON AVE # C
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4693
Practice Address - Country:US
Practice Address - Phone:661-390-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner