Provider Demographics
NPI:1720086135
Name:DELANEY, JAY ROY (OD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:ROY
Last Name:DELANEY
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 1:2305 CAMINO RAMON
Mailing Address - Street 2:#202
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1396
Mailing Address - Country:US
Mailing Address - Phone:925-866-2020
Mailing Address - Fax:925-866-2026
Practice Address - Street 1:2305 CAMINO RAMON
Practice Address - Street 2:#202
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1396
Practice Address - Country:US
Practice Address - Phone:925-866-2020
Practice Address - Fax:925-866-2026
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT10309T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S00103090Medicare ID - Type Unspecified
U64073Medicare UPIN