Individual provider Active NPI

Mary Lechner, O.D.

  • Optometrist
  • Sebastopol, CA
National Provider Identifier
1073663696
Registry record updated Oct 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9681 Issued in CA
Practice address
6880 Palm Ave
Sebastopol, CA 95472-4270
Phone
(707) 994-8644
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9681 CA Primary

Addresses

Primary practice location

6880 Palm Ave
Sebastopol, CA 95472-4270

Mailing address

2703 Gallop Dr
Santa Rosa, CA 95407-4541
Phone (707) 280-8250

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9681CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256256000000",
    "number": "1073663696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 GALLOP DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954074541",
            "telephone_number": "707-280-8250",
            "fax_number": "707-573-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6880 PALM AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724270",
            "telephone_number": "707-994-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECHNER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.