Access Laser & Vein Clinic, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

112626 Issued in CA

Legal business name

ACCESS LASER & VEIN CLINIC, INC.

Practice address

333 Sunset Ave Ste 140
Suisun City, CA 94585-2054

Phone

(707) 334-1704

NPI assigned

Sep 19, 2015

Organization subpart

No

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

Authorized official

Name

Jennifer Icasiano, BS, RVSNPI 1063889830

Title

Chief Financial Officer

Phone

(707) 334-1704

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Dela Vega Icasiano, RVS, BS

  • Vascular Sonography Radiologic Technologist
  • Suisun City, CA
  • NPI 1063889830
  NPD (past) Authorized official

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

{
    "created_epoch": "1442620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442620800000",
    "number": "1033588017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 140",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852054",
            "telephone_number": "707-334-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SUNSET AVE STE 140",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945852054",
            "telephone_number": "707-334-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS LASER & VEIN CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-19",
        "last_updated": "2015-09-19",
        "status": "A",
        "authorized_official_last_name": "ICASIANO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "707-334-1704",
        "authorized_official_credential": "BS, RVS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "112626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Adams, DC
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• Yvonne Anderson
• Analyssa Espiritu Anunciacion

• All providers in Suisun City, CA
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.