Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 183247 | CA |
NPI | 1003237835 |
---|---|
Provider Name | Ms. Jennifer H Truong |
First Address | Lakewood, CA 90715-2500 |
Second Address | Lakewood, CA 90715-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2013 |
Last Update Date | 20/12/2013 |