Valley Optometry Eyecare Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 13639T Issued in CA

Legal business name

VALLEY OPTOMETRY EYECARE CENTER, INC.

Doing business as

Valley Optometry Eyecare
Valley Optometry Eyecare of Reseda

Practice address

19636 Sherman Way
Reseda, CA 91335

Phone

(818) 774-2020

Fax

(818) 774-2021

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Andy Kongsakul, ODNPI 1497949267

Title

Director

Phone

(818) 774-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Valley Optometry Eyecare Doing business as
• Valley Optometry Eyecare of Reseda Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andy Keith Kongsakul, O.D.

  • Optometrist
  • Reseda, CA
  • NPI 1497949267
  Medicare reassignment Care Compare group NPD Authorized official
• Anne N. Shin, O.D.

  • Optometrist
  • N Hollywood, CA
  • NPI 1679742241
  Medicare reassignment Care Compare group NPD
• Zi-Lin Linda Weng, OD

  • Optometrist
  • Granada Hills, CA
  • NPI 1174300768
  Medicare reassignment Care Compare group NPD
• Kristal C Kawamoto, O.D.

  • Optometrist
  • Reseda, CA
  • NPI 1730335845
  Medicare reassignment NPD
• Mayra Carolina Lazo, OD

  • Optometrist
  • Reseda, CA
  • NPI 1023898566
  Medicare reassignment NPD
• Gina C Shao, O.D.

  • Optometrist
  • Thousand Oaks, CA
  • NPI 1023113107
  Medicare reassignment NPD
• Negin Nikahd, OD

  • Optometrist
  • Reseda, CA
  • NPI 1093154932
  NPD (past)

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1649400920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19636 SHERMAN WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-774-2020",
            "fax_number": "818-774-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 SHERMAN WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-774-2020",
            "fax_number": "818-774-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY OPTOMETRY EYECARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "KONGSAKUL",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-774-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 13639T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649400920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Optometry Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Optometry Eyecare of Reseda",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juan Antonio Valadez, DO
• Martin O Valdez
• Valley Good Family Medical Center, a Professional Corporation
• Valley Manor Board and Care Inc
• Valley Multi Specialty Surgery Center
• Valley Smile Medical Center, Inc
• Valley Vascular Institute, PC
• Valley Vascular Partners Inc
• Valley Village
• Valverde

• Optometrist in Reseda, CA
• Providers in Reseda, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.