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General NPI Number Information
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NPI Number | 1528415734
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Entity Type | Individual
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Provider Name | SANDRA JANE FRITZ OPTICIAN
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 3755 TAYLOR RD
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City | LOOMIS
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State | CA
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Zip | 95650-9226
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Country | US
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Telephone | 916-489-1110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 349
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City | PENRYN
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State | CA
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Zip | 95663-0349
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Country | US
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Telephone | 916-489-1110
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 067295
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License Number State | CA
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