Provider Demographics
NPI:1144048166
Name:RANEY, JOSEPH W III (OTC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:W
Last Name:RANEY
Suffix:III
Gender:M
Credentials:OTC
Other - Prefix:MR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:RANEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTC
Mailing Address - Street 1:5441 ELGIN HILLS WAY
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-5957
Mailing Address - Country:US
Mailing Address - Phone:209-204-8404
Mailing Address - Fax:
Practice Address - Street 1:1600 EUREKA RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3027
Practice Address - Country:US
Practice Address - Phone:916-784-5771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist