Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Edith Lopez

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083164420

Jacqueline Edith Lopez is a Student in an Organized Health Care Education/Training Program in Altadena, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

760 Mountain View St
Altadena, CA 91001-4925
Phone: (626) 798-6793
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (CA)

Record details

NPI number1083164420
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 10, 2016
Last updated in NPPESSeptember 2, 2025
Certification dateSeptember 2, 2025
Mailing address760 Mountain View St, Altadena, CA 91001-4996

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