Provider Demographics
NPI:1578283610
Name:LOPEZ CASILLAS, ARIANA
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:LOPEZ CASILLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:BOYES HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95416-0962
Mailing Address - Country:US
Mailing Address - Phone:707-332-8850
Mailing Address - Fax:
Practice Address - Street 1:425 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4500
Practice Address - Country:US
Practice Address - Phone:650-266-7569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker