Healthcare Provider Details

I. General information

NPI: 1942913421
Provider Name (Legal Business Name): VISIONAIRIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 BLUE RAVINE RD STE 400
FOLSOM CA
95630-3834
US

IV. Provider business mailing address

404 BLUE RAVINE RD STE 400
FOLSOM CA
95630-3834
US

V. Phone/Fax

Practice location:
  • Phone: 916-983-9985
  • Fax: 916-983-9950
Mailing address:
  • Phone: 916-983-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WESTON
Title or Position: OWNER
Credential: DO
Phone: 916-983-9985