Healthcare Provider Details

I. General information

NPI: 1457697799
Provider Name (Legal Business Name): MICHELE LOMELINO VALENCIA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 SAND CREEK RD FL 1
ANTIOCH CA
94531-8687
US

IV. Provider business mailing address

4501 SAND CREEK RD FL 1
ANTIOCH CA
94531-8687
US

V. Phone/Fax

Practice location:
  • Phone: 925-813-3370
  • Fax:
Mailing address:
  • Phone: 925-813-3370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: