Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jackeline Lopez, AGNP-PCP, MSN

Individual provider Registered Nurse · NPI 1225875834

Jackeline Lopez, AGNP-PCP, MSN is a Nurse Practitioner in Santa Monica, California. Qualified in 2024, 2 years ago. Practices with Our Family Medical Group Inc, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

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Practice location Address checks out

1250 16th St
Santa Monica, CA 90404-1249
Phone: (310) 825-9111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 95100221 (CA)

Record details

NPI number1225875834
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-PCP , MSN
Sole proprietorNo
NPI enumeratedJuly 10, 2024
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Our Family Medical Group Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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