Individual provider Active NPI

Stephanie Dea Sjauw, O.D.

  • Optometrist
  • Rancho Cucamonga, CA
National Provider Identifier
1831213883
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11213 Issued in CA
Practice address
12759 Foothill Blvd Suite C
Rancho Cucamonga, CA 91739
Phone
(909) 899-0026
Fax
(909) 899-6381
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11213 CA Primary

Addresses

Primary practice location

12759 Foothill Blvd Suite C
Rancho Cucamonga, CA 91739

Mailing address

12759 Foothill Blvd Suite C
Rancho Cucamonga, CA 91739
Phone (909) 899-0026

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas S Tooma M D a Professional Corporation Optometrist PastSince Mar 12, 2023 Accepting new patients
Justin T Abo O D a Professional Corporation Optometrist PastSince Nov 5, 2009 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1831213883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12759 FOOTHILL BLVD SUITE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91739",
            "telephone_number": "909-899-0026",
            "fax_number": "909-899-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12759 FOOTHILL BLVD SUITE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91739",
            "telephone_number": "909-899-0026",
            "fax_number": "909-899-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJAUW",
        "first_name": "STEPHANIE",
        "middle_name": "DEA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.