Active NPI
Jaquelyn Rojas, OD
- Optometrist
- Fullerton, CA
National Provider Identifier
1336655596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT33858TLG
- Practice address
- 400 N Acacia Ave Unit C22
Fullerton, CA 92831-4076 - Phone
- (619) 873-7255
- Fax
- (619) 873-7255
- NPI assigned
- Dec 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | OPT33858TLG | CA | Primary |
Addresses
Primary practice location
400 N Acacia Ave Unit C22
Fullerton, CA 92831-4076
Mailing address
400 N Acacia Ave Unit C22
Fullerton, CA 92831-4076
Phone (619) 873-7255
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180307001095 | CA | Practitioner - Optometry | 0840551859 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT33858TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1336655596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N ACACIA AVE UNIT C22",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314076",
"telephone_number": "619-873-7255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N ACACIA AVE UNIT C22",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314076",
"telephone_number": "619-873-7255",
"fax_number": "619-873-7255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROJAS",
"first_name": "JAQUELYN",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-22",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT33858TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.