Provider Demographics
NPI:1871052340
Name:WILLIAMS, MARIA TARANGO (OD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TARANGO
Last Name:WILLIAMS
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 1:2277 VIA ESPADA
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5837
Mailing Address - Country:US
Mailing Address - Phone:925-426-1341
Mailing Address - Fax:
Practice Address - Street 1:2277 VIA ESPADA
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5837
Practice Address - Country:US
Practice Address - Phone:925-426-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist