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General NPI Number Information
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NPI Number | 1194947895
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Entity Type | Individual
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Provider Name | JEANETTE RAE HOCHSTATTER O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 5442 YGNACIO VALLEY RD SUITE 180
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City | CONCORD
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State | CA
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Zip | 94521-3800
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Country | US
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Telephone | 925-672-4100
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Fax | 925-672-4195
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Provider Business Mailing Address
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Address Line | 635 GLASGOW CIR
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City | DANVILLE
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State | CA
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Zip | 94526-2908
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Country | US
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Telephone | 925-362-8176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 8740 TPA
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License Number State | CA
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