Active NPI
Misha Jean CHI, O.D
- Optometrist
- San Ramon, CA
National Provider Identifier
1366841017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 15014
- Practice address
- 111 Deerwood Rd Ste 300
San Ramon, CA 94583-2062 - Phone
- (925) 855-9912
- NPI assigned
- Aug 19, 2014
- 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 | 15014 | CA | Primary |
Addresses
Primary practice location
111 Deerwood Rd Ste 300
San Ramon, CA 94583-2062
Mailing address
990 Central Ave Apt 133
Riverside, CA 92507-6207
Other practice location 1
990 Central Ave Apt 133
Riverside, CA 92507-6207
Phone (408) 890-1209
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 |
|---|---|---|---|
| 15014 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1366841017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 CENTRAL AVE APT 133",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925076207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 DEERWOOD RD STE 300",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945832062",
"telephone_number": "925-855-9912"
}
],
"practiceLocations": [
{
"address_1": "990 Central Ave Apt 133",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "CA",
"postal_code": "925076207",
"country_code": "US",
"telephone_number": "408-890-1209",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHI",
"first_name": "MISHA",
"middle_name": "JEAN",
"credential": "O.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "15014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.