Provider Demographics
NPI:1952726432
Name:K AND A OPTOMETRY INC
Entity type:Organization
Organization Name:K AND A OPTOMETRY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-624-9396
Mailing Address - Street 1:2351 SUNSET BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4306
Mailing Address - Country:US
Mailing Address - Phone:916-624-9396
Mailing Address - Fax:916-624-9215
Practice Address - Street 1:2351 SUNSET BLVD STE 190
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4306
Practice Address - Country:US
Practice Address - Phone:916-624-9396
Practice Address - Fax:916-624-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13081T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA119829Medicare PIN