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General NPI Number Information
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NPI Number | 1013074160
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Entity Type | Organization
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Legal Business Name | ROBERT E PAQUETTE OPTICIAN INC
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 785 CASTRO ST STE C
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2013
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Country | US
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Telephone | 650-965-4488
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Fax |
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Provider Business Mailing Address
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Address Line | 785 CASTRO ST STE C
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2013
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Country | US
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Telephone | 650-965-4488
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Fax |
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Authorized Official
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Title or Position | CEO OPTICIAN
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Name | BONNIE ALYCE BONEY
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Credential |
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Telephone | 650-965-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number | D1917
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | D1917
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License Number State | CA
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