Provider Demographics
NPI:1922055938
Name:LOPEZ, SYLVIA (PT)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:LONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12572 VALLEY VIEW ST
Mailing Address - Street 2:ATTENTION ANN LINDBERG
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2006
Mailing Address - Country:US
Mailing Address - Phone:714-823-4400
Mailing Address - Fax:714-823-4404
Practice Address - Street 1:251 S MEDNIK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1607
Practice Address - Country:US
Practice Address - Phone:323-264-8799
Practice Address - Fax:323-264-4536
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT29179OtherPT LICENSE
CAPT29179OtherPT LICENSE