Unknown Individual – Optometrist, NPI 1619045366

Unknown Individual is a healthcare provider. based in Fair oaks, California. specializing in Optometrist. They hold a License No. 9138 T (CA). The NPI Number for Unknown Individual is 1619045366

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1619045366
Phone
(916) 692-1740
Address
3910 VILLA CT
Deactivation Date
26 February 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 3910, Villa Court, Fair Oaks, Sacramento County, California, 95628, United States

    FAIR OAKS, CA 956287422

    Phone: (916) 692-1740

    Type: Mailing

  • 5900, Sunrise Boulevard, Citrus Heights, Sacramento County, California, 95610, United States

    SUNRISE MALL

    CITRUS HEIGHTS, CA 95610

    Phone: (916) 961-0395

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95628)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1619045366.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Fair Oaks, California in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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