Active NPI
David Van Hartesvelt, OPTICIAN
- Optician
- Sylmar, CA
National Provider Identifier
1265632152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SL4082
- Practice address
- 12902 Foothill Blvd
Suite H
Sylmar, CA 91342-4900 - Phone
- (818) 837-3818
- Fax
- (818) 837-3820
- NPI assigned
- Jul 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contact Lens Fitter | 156FC0801X | CL1190 | CA | |
| Optician | 156FX1800X | SL4082 | CA | Primary |
Addresses
Primary practice location
12902 Foothill Blvd
Suite H
Sylmar, CA 91342-4900
Mailing address
12902 Foothill Blvd
Suite H
Sylmar, CA 91342-4900
Phone (818) 837-3818
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CL1190 | CA | MD | Contact Lens Fitter |
| SL4082 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1265632152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12902 FOOTHILL BLVD",
"address_2": "SUITE H",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913424900",
"telephone_number": "818-837-3818",
"fax_number": "818-837-3820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 FOOTHILL BLVD",
"address_2": "SUITE H",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913424900",
"telephone_number": "818-837-3818",
"fax_number": "818-837-3820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN HARTESVELT",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "156FC0801X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens Fitter",
"state": "CA",
"license": "CL1190",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "SL4082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.