Individual provider Active NPI

Amanda Faye Klaren, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1396876611
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12617T Issued in CA
Practice address
7910 Frost St Ste 200
San Diego, CA 92123-2776
Phone
(858) 309-7702
NPI assigned
Mar 8, 2007
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12617T CA Primary

Addresses

Primary practice location

7910 Frost St Ste 200
San Diego, CA 92123-2776

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other names 1

  • Amanda Faye Milsten Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117001239 CA Practitioner - Optometry 1658335724 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12617TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North County Eye Center, Inc. Optometrist CurrentSince Mar 1, 2019 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Feb 1, 2022 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Feb 1, 2022 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

225 E 2nd Ave
Ste 310
Escondido, CA 92025
Phone (760) 738-9985

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 966-8300

15706 Pomerado Rd
Ste 103
Poway, CA 92064
Phone (858) 451-8600

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

7910 Frost St
Ste 200
San Diego, CA 92123
Phone (858) 278-8300

Interoperability endpoints

  • Direct secure messaging: aklaren@nceyecenter.eyefinity-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1396876611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232776",
            "telephone_number": "858-309-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAREN",
        "first_name": "AMANDA",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12617T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MILSTEN",
            "middle_name": "FAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.