Provider Demographics
NPI:1083490510
Name:CK VISION OPTOMETRIC,INC.
Entity Type:Organization
Organization Name:CK VISION OPTOMETRIC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENSKY SIPES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-624-9396
Mailing Address - Street 1:52 COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5001
Mailing Address - Country:US
Mailing Address - Phone:530-823-8355
Mailing Address - Fax:530-823-8355
Practice Address - Street 1:52 COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5001
Practice Address - Country:US
Practice Address - Phone:530-823-8355
Practice Address - Fax:530-823-8355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty