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General NPI Number Information
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NPI Number | 1154116804
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Entity Type | Organization
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Legal Business Name | DR. JENNIFER JUANG, O.D., PROF. CORP.
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 2700 5TH ST
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City | ALAMEDA
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State | CA
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Zip | 94501-6574
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Country | US
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Telephone | 510-263-0382
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Fax |
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Provider Business Mailing Address
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Address Line | 909 MARINA VILLAGE PKWY # 424
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City | ALAMEDA
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State | CA
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Zip | 94501-1048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER JUANG
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Credential |
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Telephone | 510-263-0382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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