Active NPI
Darlene Taeko Okura, O.D.
- Optometrist
- Vallejo, CA
National Provider Identifier
1508997354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9329T
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0093290 | Medicaid | CA |
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9329 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 9329T | CA | MD | Corneal 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.