Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP14008 | CA |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NP14008 | CA |
NPI | 1003954116 |
---|---|
Provider Name | Mrs. Sara Ojeda Lopez |
First Address | San Diego, CA 92123-4800 |
Second Address | San Diego, CA 92123-2758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 07/02/2012 |