Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Francis Van, OD

Individual provider Optometrist · NPI 1982191110

Kenneth Francis Van, OD is an Optometry in Simi Valley, California. Graduated from Western University of Health Sciences College of Dental Med in 2017, 9 years ago. Practices with Fourth Optometric Care of California, a 25-clinician group. Licensed in California.

Years since qualifying
9
Trained at
Western University of Health Sciences College of Dental Med
Licensed in
CA
In the registry since
2018
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

5729 Nutwood Cir
Simi Valley, CA 93063-3566
Phone: (805) 587-3693
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 33905TLG (CA)

Record details

NPI number1982191110
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedApril 13, 2018
Last updated in NPPESApril 13, 2018
Mailing address5729 Nutwood Cir, Simi Valley, CA 93063-3566

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolWESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated 2017 (9 years in practice)
Group practice Fourth Optometric Care Of California — 25 clinicians
Accepts Medicare assignment Not indicated

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