Jaclyn Charbonneau, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35973 Issued in CA

Practice address

5460 E la Palma Ave
Anaheim, CA 92807-2023

Phone

(714) 463-7500

NPI assigned

May 31, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Marshall B Ketchum UniversityGroup PAC ID 9739075177, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Marshall B. Ketchum University

  • Optometrist
  • Anaheim, CA
  • NPI 1720101876
  Medicare reassignment Care Compare group NPD
• Total Vision PC

  dba Total Vision

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Care Compare group
• Marshall B. Ketchum University

  dba Ketchum Health Medical Clinic

  • Multi-Specialty Clinic/Center
  • Anaheim, CA
  • NPI 1174037493
  NPD
• Marshall B. Ketchum University/University Eye Center at Los Angeles

  dba Optometric Center of Los Angeles

  • Optometrist
  • Los Angeles, CA
  • NPI 1558467225
  NPD

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

{
    "created_epoch": "1748649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748649600000",
    "number": "1306739016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SHELTON CT",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940743",
            "telephone_number": "949-683-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072023",
            "telephone_number": "714-463-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONNEAU",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-31",
        "last_updated": "2025-05-31",
        "certification_date": "2025-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Te-Chun Chao, OTR/L
• Amanda Chaparro
• Jenny Alba Chaparro, AMFT
• Seth Chapman, MA, LMFT
• Brijesh Charadva
• Jullyn Cabrera Chargualaf, M.D.
• Arpitha Charlu, M.D.
• Charm Natural Solutions, Inc (Charm Acupuncture / Charm Clinic)
• Brian Justin Chase
• Eve Chase

• Optometrist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.