Provider Demographics
NPI:1255208476
Name:LOPEZ, KRIS JIEVA LUMANOG (RCP, RRT)
Entity type:Individual
Prefix:MS
First Name:KRIS JIEVA
Middle Name:LUMANOG
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RCP, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 AERICK ST STE 2
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4883
Mailing Address - Country:US
Mailing Address - Phone:424-800-2046
Mailing Address - Fax:424-800-2043
Practice Address - Street 1:645 AERICK ST STE 2
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4883
Practice Address - Country:US
Practice Address - Phone:424-800-2046
Practice Address - Fax:424-800-2043
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33662227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered