Active NPI
Sandra Irene Peraza, R.D.O
- Optician
- Clovis, CA
National Provider Identifier
1649560905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SL2416
- Practice address
- 426 W Shaw Ave
Clovis, CA 93612-3207 - Phone
- (559) 298-8262
- Fax
- (559) 298-7295
- NPI assigned
- Apr 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | SL2416 | CA | Primary |
Addresses
Primary practice location
426 W Shaw Ave
Clovis, CA 93612-3207
Mailing address
426 W Shaw Ave
Clovis, CA 93612-3207
Phone (559) 298-8262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL2416 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1649560905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 W SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936123207",
"telephone_number": "559-298-8262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 W SHAW AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936123207",
"telephone_number": "559-298-8262",
"fax_number": "559-298-7295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERAZA",
"first_name": "SANDRA",
"middle_name": "IRENE",
"name_prefix": "Mrs.",
"credential": "R.D.O",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "SL2416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.