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General NPI Number Information
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NPI Number | 1730074469
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Entity Type | Individual
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Provider Name | ISABELLA SUSANNE TERRY OD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 395 CIVIC DR STE G
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City | PLEASANT HILL
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State | CA
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Zip | 94523-1950
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Country | US
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Telephone | 925-676-8365
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Fax |
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Provider Business Mailing Address
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Address Line | 54 ALAN DR
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City | PLEASANT HILL
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State | CA
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Zip | 94523-1902
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Country | US
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Telephone | 925-852-1672
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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 | 36006
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License Number State | CA
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