Provider Demographics
NPI:1992242788
Name:ANDRADE LOPEZ, GABRIELA G (FNP-C)
Entity type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:G
Last Name:ANDRADE LOPEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:GABRIELA
Other - Middle Name:G
Other - Last Name:ANDRADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:409 E PALMER ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-2611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 E PALMER ST
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-2611
Practice Address - Country:US
Practice Address - Phone:424-237-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily