Provider Demographics
NPI:1871136531
Name:AQUINO, JEREMY JARAMILLA (OD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:JARAMILLA
Last Name:AQUINO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 CALLA LILY CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-0428
Mailing Address - Country:US
Mailing Address - Phone:805-428-6432
Mailing Address - Fax:
Practice Address - Street 1:14757 POMERADO RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2802
Practice Address - Country:US
Practice Address - Phone:858-842-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34672152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist