Healthcare Provider Details

I. General information

NPI: 1346166618
Provider Name (Legal Business Name): JENNY TAI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W 20TH ST STE A
MERCED CA
95340-3639
US

IV. Provider business mailing address

16770 WILLOW CREEK DR
MORGAN HILL CA
95037-4826
US

V. Phone/Fax

Practice location:
  • Phone: 209-384-2335
  • Fax:
Mailing address:
  • Phone: 408-466-5377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36321
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: