Provider Demographics
NPI:1073251369
Name:CEPEDA, OLIVIA ADRIANA (OD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:ADRIANA
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33444 ALVARADO NILES RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3110
Mailing Address - Country:US
Mailing Address - Phone:510-487-1335
Mailing Address - Fax:
Practice Address - Street 1:33444 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3110
Practice Address - Country:US
Practice Address - Phone:510-487-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist