Healthcare Provider Details

I. General information

NPI: 1568380038
Provider Name (Legal Business Name): MAYOLI BADONI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5575 W LAS POSITAS BLVD STE 240
PLEASANTON CA
94588-5803
US

IV. Provider business mailing address

7963 KIPLING CIR
GILROY CA
95020-5535
US

V. Phone/Fax

Practice location:
  • Phone: 925-460-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: