Individual provider Active NPI

Kathryn Dugan, O.D.

  • Vision Therapy Optometrist
  • Temecula, CA
National Provider Identifier
1104230663
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
14952 Issued in CA
Practice address
31333 Temecula Pkwy
Suite #C10-140
Temecula, CA 92592-6820
Phone
(951) 302-1331
Fax
(866) 812-6094
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 14952 CA Primary

Addresses

Primary practice location

31333 Temecula Pkwy
Suite #C10-140
Temecula, CA 92592-6820

Mailing address

31333 Temecula Pkwy
Suite #C10-140
Temecula, CA 92592-6820
Phone (951) 302-1331

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
14952CAMDVision Therapy Optometrist
7894CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Giovanni Venittelli OD Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1104230663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31333 TEMECULA PKWY",
            "address_2": "SUITE #C10-140",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926820",
            "telephone_number": "951-302-1331",
            "fax_number": "866-812-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31333 TEMECULA PKWY",
            "address_2": "SUITE #C10-140",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926820",
            "telephone_number": "951-302-1331",
            "fax_number": "866-812-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "14952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.