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Individual

DR. AMY LIU LYNN LONGACRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
6155 STONERIDGE DR, SUITE 100, PLEASANTON, CA 94588-3204
(925) 463-2150
(925) 463-1186
Mailing address
3591 CRESPI CT, PLEASANTON, CA 94566-7561
(925) 463-2150
(925) 463-1186

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7518TPL
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
680505388
GROUPS FED'S ID NUMBER
CA
05
SD0009280
CA
Enumeration date
01/25/2006
Last updated
07/15/2008
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