Active NPI
Ganiece Gaubatz
- Optician
- Irvine, CA
National Provider Identifier
1003569955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 42517
- Practice address
- 3981 Irvine Blvd
Irvine, CA 92602-2400 - Phone
- (714) 338-1603
- Fax
- (714) 368-4722
- NPI assigned
- Feb 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 42517 | CA | Primary |
Addresses
Primary practice location
3981 Irvine Blvd
Irvine, CA 92602-2400
Mailing address
1 CVS Drive
Mail Stop #3005
Woonsocket, RI 02895
Phone (401) 770-2286
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42517 | CA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Aoc Corporation | Optician | Current | Accepting new patients |
Locations
1 Cvs Dr
Stop 3005
Woonsocket, RI 02895
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optician
- Carson, CA
- NPI 1649822628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1003569955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DRIVE",
"address_2": "MAIL STOP #3005",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "02895",
"telephone_number": "401-770-2286",
"fax_number": "401-269-4731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3981 IRVINE BLVD",
"city": "IRVINE",
"state": "CA",
"postal_code": "926022400",
"telephone_number": "714-338-1603",
"fax_number": "714-368-4722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUBATZ",
"first_name": "GANIECE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-01",
"last_updated": "2022-02-01",
"certification_date": "2022-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "42517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.