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General NPI Number Information
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NPI Number | 1356408231
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Entity Type | Individual
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Provider Name | DEBRA SUSN ATCHINSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | KAISER PERMANENTE 7601 STONERIDGE DR.
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City | PLEASANTON
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State | CA
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Zip | 94588-2899
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Country | US
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Telephone | 385-847-5247
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Fax |
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Provider Business Mailing Address
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Address Line | 2726 TAHOE DR
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City | LIVERMORE
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State | CA
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Zip | 94550-6626
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Country | US
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Telephone | 925-443-8906
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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 | 8723T
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License Number State | CA
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