Provider Demographics
NPI:1578501532
Name:RANSBERGER, JUDITH LANE (OD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LANE
Last Name:RANSBERGER
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 1:5021 W NOBLE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8310
Mailing Address - Country:US
Mailing Address - Phone:559-627-9393
Mailing Address - Fax:559-627-1624
Practice Address - Street 1:5021 W NOBLE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8310
Practice Address - Country:US
Practice Address - Phone:559-627-9393
Practice Address - Fax:559-627-1624
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8771TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T10715Medicare UPIN
CASD0087712Medicare PIN