Provider Demographics
NPI:1437337748
Name:LOPEZ, VANESSA (RN)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:BURGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1101 W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1811
Mailing Address - Country:US
Mailing Address - Phone:818-557-4191
Mailing Address - Fax:818-295-2545
Practice Address - Street 1:1101 W MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1811
Practice Address - Country:US
Practice Address - Phone:818-557-4191
Practice Address - Fax:818-295-2545
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516389163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management