Provider Demographics
NPI:1356408231
Name:ATCHINSON, DEBRA SUSN (OD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUSN
Last Name:ATCHINSON
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 1:2726 TAHOE DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6626
Mailing Address - Country:US
Mailing Address - Phone:925-443-8906
Mailing Address - Fax:
Practice Address - Street 1:KAISER PERMANENTE 7601 STONERIDGE DR.
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2899
Practice Address - Country:US
Practice Address - Phone:385-847-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8723T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist