Provider Demographics
NPI:1104926393
Name:CAPUTO, CAREEN (OD)
Entity type:Individual
Prefix:DR
First Name:CAREEN
Middle Name:
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:CAREEN
Other - Middle Name:
Other - Last Name:GIESBRECHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1441 CONSTITUTION BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3136
Mailing Address - Country:US
Mailing Address - Phone:831-424-1150
Mailing Address - Fax:831-424-1158
Practice Address - Street 1:891 SUNSET DR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5601
Practice Address - Country:US
Practice Address - Phone:831-637-7471
Practice Address - Fax:831-637-7472
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9898T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0098980Medicare ID - Type Unspecified
U46204Medicare UPIN