MEDICARE: DR. VANESSA FERRUCCI O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	12117T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851368419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA FERRUCCI O.D.

Provider Business Mailing Address
First Line	:	14610 MORRISON ST
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-1649
Country	:	US
Telephone Number	:	818-789-2809
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 W ALAMEDA AVE
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4195
Country	:	US
Telephone Number	:	818-841-1212
Fax Number	:	818-841-6768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	01/09/2016

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