Provider Demographics
NPI:1922257831
Name:LAUREL, JOSEPHINE VO (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:VO
Last Name:LAUREL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOSEPHINE
Other - Middle Name:KIM
Other - Last Name:VO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3133 W MARCH LN
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2361
Mailing Address - Country:US
Mailing Address - Phone:209-951-0820
Mailing Address - Fax:209-951-2348
Practice Address - Street 1:3133 W MARCH LN
Practice Address - Street 2:SUITE 2020
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2361
Practice Address - Country:US
Practice Address - Phone:209-951-0820
Practice Address - Fax:209-951-2348
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist