Provider Demographics
NPI:1013243807
Name:SCHRUPP, LAURA E (OD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:SCHRUPP
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 1:3 DE SOTO CT
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-1930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2852 REDWOOD PKWY
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-3698
Practice Address - Country:US
Practice Address - Phone:707-553-8222
Practice Address - Fax:707-553-1154
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13851152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist