Provider Demographics
NPI:1528416435
Name:LOPEZ, CYNTHIA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:255 E BONITA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-1923
Mailing Address - Country:US
Mailing Address - Phone:909-593-7437
Mailing Address - Fax:909-593-0318
Practice Address - Street 1:255 E BONITA AVE STE 101
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-1923
Practice Address - Country:US
Practice Address - Phone:909-593-7437
Practice Address - Fax:909-593-0318
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP95004390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily