Provider Demographics
NPI:1457681892
Name:SHECK, ANITA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:SHECK
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 1:895 E H ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7807
Mailing Address - Country:US
Mailing Address - Phone:619-397-7955
Mailing Address - Fax:619-397-7956
Practice Address - Street 1:895 E H ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7807
Practice Address - Country:US
Practice Address - Phone:619-397-7955
Practice Address - Fax:619-397-7956
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13823152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist