Healthcare Provider Details

I. General information

NPI: 1487624995
Provider Name (Legal Business Name): VERONICA JULIE STAPLES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901B SANTA RITA RD
PLEASANTON CA
94588-3462
US

IV. Provider business mailing address

5253 ASPEN ST
DUBLIN CA
94568-7675
US

V. Phone/Fax

Practice location:
  • Phone: 925-463-2150
  • Fax: 925-463-1186
Mailing address:
  • Phone: 925-463-2150
  • Fax: 925-463-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9828TPL
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: