Provider Demographics
NPI:1558336628
Name:WOMACK, CHRISTINA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3885 COCHRAN ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2369
Mailing Address - Country:US
Mailing Address - Phone:805-522-7007
Mailing Address - Fax:805-522-7886
Practice Address - Street 1:3885 COCHRAN ST
Practice Address - Street 2:SUITE L
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2369
Practice Address - Country:US
Practice Address - Phone:805-522-7007
Practice Address - Fax:805-522-7886
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11083T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU72836Medicare UPIN