Healthcare Provider Details

I. General information

NPI: 1083591432
Provider Name (Legal Business Name): JAIME VOONG OPTOMETRIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 ROBERTS LN
BAKERSFIELD CA
93308-4799
US

IV. Provider business mailing address

525 ROBERTS LN
BAKERSFIELD CA
93308-4799
US

V. Phone/Fax

Practice location:
  • Phone: 866-707-6664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: