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General NPI Number Information
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NPI Number | 1164095220
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Entity Type | Individual
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Provider Name | JENNIFER JIAYUN ZHANG YOO OD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 901 DOVER DR STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5514
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Country | US
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Telephone | 949-642-0292
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Fax |
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Provider Business Mailing Address
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Address Line | 901 DOVER DR STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5514
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Country | US
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Telephone | 949-642-0292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 35139TLG
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 35139TLG
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License Number State | CA
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