Active NPI
Ellen Beth Liebowitz, OD
- Optometrist
- Woodland, CA
National Provider Identifier
1194897132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- CA 7260T
- Practice address
- 421 Pioneer Ave Ste B
Woodland, CA 95776-4948 - Phone
- (530) 661-0300
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | CA 7260T | CA | Primary |
Addresses
Primary practice location
421 Pioneer Ave Ste B
Woodland, CA 95776-4948
Mailing address
421 B Pioneer Ave
Woodland, CA 95776
Phone (530) 661-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0072600 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CA 7260T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1194897132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 B PIONEER AVE",
"city": "WOODLAND",
"state": "CA",
"postal_code": "95776",
"telephone_number": "530-661-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 PIONEER AVE STE B",
"city": "WOODLAND",
"state": "CA",
"postal_code": "957764948",
"telephone_number": "530-661-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBOWITZ",
"first_name": "ELLEN",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "CA 7260T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0072600",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.