Provider Demographics
NPI:1013139138
Name:LOPEZ, AURELIA E II (LVN)
Entity Type:Individual
Prefix:MRS
First Name:AURELIA
Middle Name:E
Last Name:LOPEZ
Suffix:II
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 1:81960 TOURNAMENT WAY
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-3047
Mailing Address - Country:US
Mailing Address - Phone:760-347-9164
Mailing Address - Fax:
Practice Address - Street 1:82297 MILES AVE
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4116
Practice Address - Country:US
Practice Address - Phone:760-342-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 61670164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPS012150OtherMEDICAL