Provider Demographics
NPI:1124401427
Name:SOO HOO, JENNY MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:MICHELLE
Last Name:SOO HOO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13089 PEYTON DR # C377
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:511 E GARVEY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-1974
Practice Address - Country:US
Practice Address - Phone:626-382-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-04
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002635152W00000X
VT030.0133970152W00000X
WAOD61555235152W00000X
MI4901005864152W00000X
COOPT.0004092152W00000X
NV1207152W00000X
UT13880118-9934152W00000X
NMOPT-2024-0007152W00000X
MTOPT-OPT-LIC-5271152W00000X
IDODP-100665152W00000X
OR4748152W00000X
CA15351152W00000X
WI371835152W00000X
VA0618002998152W00000X
WI3718-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist