Individual provider Active NPI

Laura Leticia Garnica, OD

  • Optometrist
  • Colton, CA
National Provider Identifier
1598348468
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34798 Issued in CA
Practice address
1120 S Mount Vernon Ave
Colton, CA 92324-4220
Phone
(909) 783-4850
NPI assigned
Apr 29, 2021
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34798 CA Primary

Addresses

Primary practice location

1120 S Mount Vernon Ave
Colton, CA 92324-4220

Mailing address

12767 Bridgewater Dr
Eastvale, CA 92880-8848

Other practice location 1

15740 Whittwood Ln
Whittier, CA 90603-2326
Phone (562) 943-0118

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
I20230405001042 CA Practitioner - Optometry 5799150710 Reassigns benefits to 1 organization
Practice locations: Colton, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Garnica Optometry Optometrist CurrentSince Feb 2, 2023 Accepting new patients
Garnica Optometric Group, PC Optometrist Current Accepting new patients
Tedder Optometric Clinic Management, P.C. Optometrist CurrentSince Aug 14, 2023 Accepting new patients
Usv Optical Inc PastSince May 1, 2021 Accepting new patients
Tedder Optometry Group, PC Optometrist PastSince Mar 24, 2024 Accepting new patients
Usv Optical Inc Optometrist PastSince May 1, 2021 Accepting new patients

Locations

1120 S Mount Vernon Ave
Colton, CA 92324
Phone (909) 783-0390

15268 Summit Ave
Ste 300
Fontana, CA 92336
Phone (909) 279-2424

17064 Slover Ave
Ste 104
Fontana, CA 92337
Phone (909) 258-4380

530 New Los Angeles Ave
Ste 115269
Moorpark, CA 93021
Phone (805) 624-1255

Organizations & group practices 6

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1598348468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12767 BRIDGEWATER DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244220",
            "telephone_number": "909-783-4850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15740 Whittwood Ln",
            "address_purpose": "LOCATION",
            "city": "Whittier",
            "state": "CA",
            "postal_code": "906032326",
            "country_code": "US",
            "telephone_number": "562-943-0118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARNICA",
        "first_name": "LAURA",
        "middle_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.