Individual provider Active NPI

Rachel Kaneta

  • Optometrist
  • Walnut Creek, CA
National Provider Identifier
1891072906
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
33794 Issued in CA
Practice address
1871 N Main St
Walnut Creek, CA 94596-4106
Phone
(925) 627-8230
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP100335 ID
Optometrist 152W00000X 33794 CA Primary

Addresses

Primary practice location

1871 N Main St
Walnut Creek, CA 94596-4106

Mailing address

2800 Dublin Blvd
Dublin, CA 94568-4589
Phone (925) 241-1054

Other practice location 1

2800 Dublin Blvd
Dublin, CA 94568-4589
Phone (925) 241-1054

Other identifiers 1

IdentifierTypeStateIssuer
33794OtherCACALIFORNIA STATE BOARD OF OPTOMETRY TLG

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
I20180613002838 CA Practitioner - Optometry 4385951169 Practice locations: Dublin, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33794CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel Kaneta OD Optometrist CurrentSince May 21, 2023 Accepting new patients
Raymond F Pedersen O.D. Professional Optometrist PastSince May 1, 2016 Accepting new patients

Locations

2800 Dublin Blvd
Dublin, CA 94568
Phone (925) 241-1043

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": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1891072906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945684589",
            "telephone_number": "925-241-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 N MAIN ST",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964106",
            "telephone_number": "925-627-8230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Dublin Blvd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "CA",
            "postal_code": "945684589",
            "country_code": "US",
            "telephone_number": "925-241-1054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANETA",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100335",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF OPTOMETRY TLG",
            "identifier": "33794",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.