Provider Demographics
NPI:1275898215
Name:CHINONE, JOLYN THUY VI (OD)
Entity Type:Individual
Prefix:
First Name:JOLYN
Middle Name:THUY VI
Last Name:CHINONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOLYN
Other - Middle Name:THUY VI
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:169 SUN VALLEY MALL
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5804
Mailing Address - Country:US
Mailing Address - Phone:925-682-8884
Mailing Address - Fax:925-682-5390
Practice Address - Street 1:169 SUN VALLEY MALL
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5804
Practice Address - Country:US
Practice Address - Phone:925-682-8884
Practice Address - Fax:925-682-5390
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007888152W00000X
CA15203152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist