Healthcare Provider Details

I. General information

NPI: 1912894098
Provider Name (Legal Business Name): VANESSA GAMEZ-LUNA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8246 LAGUNA BLVD STE 300
ELK GROVE CA
95758-7972
US

IV. Provider business mailing address

8246 LAGUNA BLVD
ELK GROVE CA
95758-7968
US

V. Phone/Fax

Practice location:
  • Phone: 916-684-6688
  • Fax:
Mailing address:
  • Phone: 916-684-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: