Provider Demographics
NPI:1447258868
Name:RASNER, VALERIE (OD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:RASNER
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 1:19530 VAN BUREN BLVD
Mailing Address - Street 2:SUITE G-8
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-9455
Mailing Address - Country:US
Mailing Address - Phone:951-656-0500
Mailing Address - Fax:951-697-0101
Practice Address - Street 1:19530 VAN BUREN BLVD
Practice Address - Street 2:SUITE G-8
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-9455
Practice Address - Country:US
Practice Address - Phone:951-656-0500
Practice Address - Fax:951-697-0101
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-09
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10725T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0107250Medicaid
CA1447258868Medicaid