Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 152WL0500X | Optometrist | Low Vision Rehabilitation | OPT 11120TPA | CALIFORNIA | No |
| 2 | 152WP0200X | Optometrist | Pediatrics | OPT 11120TPA | CALIFORNIA | No |
| 3 | 152WS0006X | Optometrist | Sports Vision | OPT 11120TPA | CALIFORNIA | No |
| 4 | 152WV0400X | Optometrist | Vision Therapy | OPT 11120TPA | CALIFORNIA | No |
| 5 | 152WC0802X | Optometrist | Corneal and Contact Management | OPT 11120TPA | CALIFORNIA | No |
| 6 | 152W00000X | Optometrist | | OPT 11120TPA | CALIFORNIA | Yes |
| 7 | 152WX0102X | Optometrist | Occupational Vision | OPT 11120TPA | CALIFORNIA | No |