Earle Baum Center of the Blind Inc.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

8817T Issued in CA

Legal business name

EARLE BAUM CENTER OF THE BLIND INC.

Practice address

4539 Occidental Rd
Santa Rosa, CA 95401-5635

Phone

(707) 523-3222

Fax

(707) 636-2768

NPI assigned

Feb 3, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Allan Brenner

Title

President/Ceo

Phone

(707) 523-3222

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1013249986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 OCCIDENTAL RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015635",
            "telephone_number": "707-523-3222",
            "fax_number": "707-636-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 OCCIDENTAL RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015635",
            "telephone_number": "707-523-3222",
            "fax_number": "707-636-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLE BAUM CENTER OF THE BLIND INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-523-3222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "8817T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Dwyer
• Katherine Dyer, LMFT
• Michael Kent Dyer, BCBA
• Donna Beth Eakin, OTR/L, CHT
• Isabella Brodie Earl
• Norman E Easley, N.D.
• East-West Natural Medicine Inc.
• Easter Seals Bay Area
• Simone Easterbrook, DO
• Grace Eastham

• Low Vision Rehabilitation Optometrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Low Vision Rehabilitation Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.