Provider Demographics
NPI:1881315240
Name:REZZO, CAMERYN PRESS (OD)
Entity type:Individual
Prefix:
First Name:CAMERYN
Middle Name:PRESS
Last Name:REZZO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CAMERYN
Other - Middle Name:PRESS
Other - Last Name:AHLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6699 N WOODSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1152
Mailing Address - Country:US
Mailing Address - Phone:559-240-5911
Mailing Address - Fax:
Practice Address - Street 1:6767 N FRESNO ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3740
Practice Address - Country:US
Practice Address - Phone:559-332-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35257152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist