Provider Demographics
NPI:1164095220
Name:ZHANG YOO, JENNIFER JIAYUN (OD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JIAYUN
Last Name:ZHANG YOO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:JIAYUN
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:901 DOVER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5514
Mailing Address - Country:US
Mailing Address - Phone:949-642-0292
Mailing Address - Fax:
Practice Address - Street 1:901 DOVER DR STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5514
Practice Address - Country:US
Practice Address - Phone:949-642-0292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35139TLG152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152W00000XEye and Vision Services ProvidersOptometrist