Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | CL1473 | CA |
N | 156FX1800X | Optician | SL5256 | CA |
NPI | 1760604797 |
---|---|
Provider Name | Ms. Reina A Zelaya |
First Address | Reseda, CA 91335-4207 |
Second Address | Reseda, CA 91335-4207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |