Healthcare Provider Details

I. General information

NPI: 1225701733
Provider Name (Legal Business Name): VALERIE ANULI OKAKPU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 06/18/2023
Certification Date: 06/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 LONE TREE WAY STE A
ANTIOCH CA
94531-8690
US

IV. Provider business mailing address

2020 DATE ST
CONCORD CA
94519-2516
US

V. Phone/Fax

Practice location:
  • Phone: 925-757-0450
  • Fax:
Mailing address:
  • Phone: 408-393-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003822
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3013-IOD
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT35413-TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: