Jennifer Sodanet Castillo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

15317 Issued in CA

Practice address

2156 Montebello Town Ctr
Montebello, CA 90640-2170

Phone

(310) 546-5568

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Sodanet Khem Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye People Optometry, Inc.

  • Optometrist
  • Montebello, CA
  • NPI 1396259669
  Medicare reassignment NPD

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1023423548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 MONTEBELLO TOWN CTR",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402170",
            "telephone_number": "310-546-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 MONTEBELLO TOWN CTR",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402170",
            "telephone_number": "310-546-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "JENNIFER",
        "middle_name": "SODANET",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KHEM",
            "middle_name": "SODANET",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mayra Alejandra Carrillo
• Casa Cardenas
• Casa del Sol Adult Day Health Care Center LLC
• Michele Lee Casanova
• Faviola Castillo, MSW
• Jacqueline Castro, DDS
• Jairo Castro, D.D.S.
• Catherine Huang, O.D. a Professional Corporation
• Garrett Way Wong Cecchini, DDS
• James J Cecchini III, D.D.S.

• Optometrist in Montebello, CA
• Providers in Montebello, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.