Provider Demographics
NPI:1518002344
Name:YEN, LUCY (OD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:
Last Name:YEN
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 1:1335 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-3022
Mailing Address - Country:US
Mailing Address - Phone:408-294-9900
Mailing Address - Fax:408-294-9900
Practice Address - Street 1:526 WATER WITCH WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1653
Practice Address - Country:US
Practice Address - Phone:260-312-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12476 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist