Healthcare Provider Details

I. General information

NPI: 1528102993
Provider Name (Legal Business Name): JAMIE HANCOCK O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 VAN NESS AVE STE 300
SAN FRANCISCO CA
94102-3286
US

IV. Provider business mailing address

PO BOX 103888 SUITE #300
PASADENA CA
91189-3888
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-8200
  • Fax: 415-567-2973
Mailing address:
  • Phone: 415-567-8200
  • Fax: 415-567-2973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10328T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: