Provider Demographics
NPI:1104509652
Name:LOPEZ PACHECO, MARIA GUADALUPE
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GUADALUPE
Last Name:LOPEZ PACHECO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-0510
Mailing Address - Country:US
Mailing Address - Phone:209-669-6771
Mailing Address - Fax:209-669-6786
Practice Address - Street 1:1700 MCHENRY VILLAGE WAY STE 14
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4339
Practice Address - Country:US
Practice Address - Phone:209-312-9580
Practice Address - Fax:209-312-9584
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program