Tami Loraine Wallan

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT12287 Issued in CA

Practice address

530 Main St
Red Bluff, CA 96080-3438

Phone

(530) 529-1750

Fax

(530) 435-6074

NPI assigned

Mar 6, 2023

Last updated

Mar 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Northridge Eye Care, a Professional Corporation

  • Ophthalmology Physician
  • Red Bluff, CA
  • NPI 1154759785

  Optometrist

  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1568162899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 MAIN ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803438",
            "telephone_number": "530-529-1750",
            "fax_number": "530-435-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MAIN ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803438",
            "telephone_number": "530-529-1750",
            "fax_number": "530-435-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLAN",
        "first_name": "TAMI",
        "middle_name": "LORAINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margie Wahl, DACII
• Kerry S. Waits, D.O.
• Kevin A Waits, D.O.
• Melissa Walgamuth, PA-C
• Walgreen Co (Walgreens #07653)
• Walmart Inc. (Walmart Pharmacy 10-1608)
• Sarah G Walsh
• Rachael Waltz
• Kyle Wasson
• Kelly Watkins

• Optometrist in Red Bluff, CA
• Providers in Red Bluff, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.