Individual provider Active NPI

John Kiyoshi Fujii, O.D.

  • Optometrist
  • Stockton, CA
National Provider Identifier
1104883149
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9652T Issued in CA
Practice address
36 W Yokuts Ave Ste 1
Stockton, CA 95207-5713
Phone
(209) 952-0553
Fax
(209) 952-0553
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9652T CA Primary
Corneal and Contact Management Optometrist 152WC0802X OPT9652 CA

Addresses

Primary practice location

36 W Yokuts Ave Ste 1
Stockton, CA 95207-5713

Mailing address

36 W Yokuts Ave Ste 1
Stockton, CA 95207-5713
Phone (209) 952-3700

Other practice location 1

200 Cottage Ave Ste 102
Manteca, CA 95336-4935
Phone (209) 239-5303

Other practice location 2

1334 Nelson Ave
Modesto, CA 95350-5341
Phone (209) 579-8800

Other practice location 3

3133 W March Ln
Suite 2020
Stockton, CA 95219-2361
Phone (209) 951-0820

Other identifiers 1

IdentifierTypeStateIssuer
SD0096523MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080613000372 CA Practitioner - Optometry 3678644994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Optometric Care of Northern California PCGroup PAC ID 6002216488, 18 clinicians

Practice addresses (Care Compare)

3133 W March LN
Suite 2020
Stockton, CA 95219-2361
Phone (916) 407-7156

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9652TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
First Optometric Care of Northern California PC Optometrist Current Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients
First Optometric Care of Northern California PC Optometrist CurrentSince Mar 10, 2021 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

100 S Harding Blvd
Roseville, CA 95678
Phone (916) 783-8109

3133 W March Ln
Ste 2020
Stockton, CA 95219
Phone (209) 951-0820

Organizations & group practices 3

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1104883149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W YOKUTS AVE STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075713",
            "telephone_number": "209-952-3700",
            "fax_number": "209-952-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W YOKUTS AVE STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075713",
            "telephone_number": "209-952-0553",
            "fax_number": "209-952-0553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Cottage Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953364935",
            "country_code": "US",
            "telephone_number": "209-239-5303",
            "fax_number": "209-239-0090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1334 Nelson Ave",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953505341",
            "country_code": "US",
            "telephone_number": "209-579-8800",
            "fax_number": "209-579-1407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3133 W March Ln",
            "address_2": "Suite 2020",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952192361",
            "country_code": "US",
            "telephone_number": "209-951-0820",
            "fax_number": "209-951-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUJII",
        "first_name": "JOHN",
        "middle_name": "KIYOSHI",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9652T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "OPT9652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0096523",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.