Corinne Rouault Odineal, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 8316 TPA Issued in CA

Practice address

3133 Professional Dr Ste 14
Auburn, CA 95603-2463

Phone

(530) 888-0670

Fax

(530) 888-8652

NPI assigned

Nov 2, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 8, 2021 through Nov 8, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• In Depth Vision Optometry PC

  • Optometrist
  • Auburn, CA
  • NPI 1689276651
  NPD Authorized official

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073692018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3262 FORTUNE CT",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956027847",
            "telephone_number": "530-830-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 PROFESSIONAL DR STE 14",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032463",
            "telephone_number": "530-888-0670",
            "fax_number": "530-888-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODINEAL",
        "first_name": "CORINNE",
        "middle_name": "ROUAULT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-03-07",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "OPT 8316 TPA",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "OPT 8316 TPA",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "OPT 8316 TPA",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "CA",
            "license": "OPT 8316 TPA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 8316 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.