Provider Demographics
NPI:1790190494
Name:VU, JACQUELINE YEN-CHI (OD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:YEN-CHI
Last Name:VU
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 1:18426 BROOKHURST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6777
Mailing Address - Country:US
Mailing Address - Phone:714-546-2020
Mailing Address - Fax:
Practice Address - Street 1:18426 BROOKHURST ST STE 103
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6777
Practice Address - Country:US
Practice Address - Phone:714-546-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14951152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist