Individual provider Active NPI

Darlene Taeko Okura, O.D.

  • Optometrist
  • Vallejo, CA
National Provider Identifier
1508997354
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9329T Issued in CA
Practice address
3505 Sonoma Blvd
Suite #30
Vallejo, CA 94590-2920
Phone
(707) 643-1003
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9329T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 9329T CA
Pediatric Optometrist 152WP0200X 9329T CA

Addresses

Primary practice location

3505 Sonoma Blvd
Suite #30
Vallejo, CA 94590-2920

Mailing address

3505 Sonoma Blvd
Suite #30
Vallejo, CA 94590-2920
Phone (707) 643-1003

Other identifiers 1

IdentifierTypeStateIssuer
SD0093290MedicaidCA

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
I20111207000155 CA Practitioner - Optometry 3971778713 Practice locations: Vallejo, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3505 Sonoma Blvd
Suite 30
Vallejo, CA 94590-2920
Phone (707) 643-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9329CAMDAddiction (Substance Use Disorder) Counselor
9329TCAMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1508997354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 SONOMA BLVD",
            "address_2": "SUITE #30",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902920",
            "telephone_number": "707-643-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 SONOMA BLVD",
            "address_2": "SUITE #30",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902920",
            "telephone_number": "707-643-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKURA",
        "first_name": "DARLENE",
        "middle_name": "TAEKO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9329T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "9329T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "9329T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0093290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.