Provider Demographics
NPI:1609810928
Name:LANNIN, JANANI K (OD)
Entity Type:Individual
Prefix:
First Name:JANANI
Middle Name:K
Last Name:LANNIN
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 1:1950 COURT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1823
Mailing Address - Country:US
Mailing Address - Phone:530-241-0778
Mailing Address - Fax:
Practice Address - Street 1:1950 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1823
Practice Address - Country:US
Practice Address - Phone:530-241-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0072320Medicaid
CA0999770001Medicare NSC
CAT38777Medicare UPIN
CASD0072321Medicare PIN