Provider Demographics
NPI:1427859511
Name:LOPEZ, AYLIN (MS, RDN)
Entity type:Individual
Prefix:
First Name:AYLIN
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 RED BARK RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-2438
Mailing Address - Country:US
Mailing Address - Phone:805-268-4272
Mailing Address - Fax:
Practice Address - Street 1:1069 RED BARK RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-2438
Practice Address - Country:US
Practice Address - Phone:805-268-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86301747133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered