Lisa Clark Verdon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

09725T Issued in CA

Practice address

1313 Solano Ave
Albany, CA 94706-1825

Phone

(510) 526-0194

Fax

(510) 524-2471

NPI assigned

Sep 14, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Berkeley California Optometric, Inc

  • Optometrist
  • Albany, CA
  • NPI 1518314962
  NPD (past)
• East Bay Eye Centers Medical Corporation

  • Specialist
  • San Ramon, CA
  • NPI 1780633644
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689779415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 SOLANO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061825",
            "telephone_number": "510-526-0194",
            "fax_number": "510-524-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 SOLANO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061825",
            "telephone_number": "510-526-0194",
            "fax_number": "510-524-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDON",
        "first_name": "LISA",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "09725T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0097250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Kay Ulmer, LCSW
• Kelsey C Underwood, PHD, LMFT
• Jan Van Der Zwaag, MFT
• Loraine Y Van Tuyl, PHD
• Michelle Tirella Ventura
• Stephen Adair Vernon, MFT
• Emily Cristina Viggiano, M.D.
• Laurie Vollen, MD
• Michael D Voyne, D.D.S.
• Sandra Waggener, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.