Individual provider Active NPI

Brenda I Sutton, O.D.

  • Optometrist
  • Walnut Creek, CA
National Provider Identifier
1215020342
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11812T Issued in CA
Practice address
1599 Botelho Dr
Walnut Creek, CA 94596-5102
Phone
(925) 945-8300
Fax
(925) 945-8757
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11812T CA Primary

Addresses

Primary practice location

1599 Botelho Dr
Walnut Creek, CA 94596-5102

Mailing address

1599 Botelho Dr
Walnut Creek, CA 94596-5102
Phone (925) 945-8300

Other names 1

  • Mrs. Brenda I Rodriguez-Aguilar Former name

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
11812TCAMDOptometrist
11821CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1215020342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 BOTELHO DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965102",
            "telephone_number": "925-945-8300",
            "fax_number": "925-945-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 BOTELHO DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965102",
            "telephone_number": "925-945-8300",
            "fax_number": "925-945-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "BRENDA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11812T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "RODRIGUEZ-AGUILAR",
            "middle_name": "I",
            "prefix": "MRS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.