Provider Demographics
NPI:1346325933
Name:CURTIS, CHRISTY JOY (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:JOY
Last Name:CURTIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTY
Other - Middle Name:JOY
Other - Last Name:MIZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:8246 LAGUNA BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7972
Mailing Address - Country:US
Mailing Address - Phone:916-684-6688
Mailing Address - Fax:916-687-6721
Practice Address - Street 1:8246 LAGUNA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7968
Practice Address - Country:US
Practice Address - Phone:916-684-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12797152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEO089AMedicare PIN