Provider Demographics
NPI:1457922957
Name:TRAN, JESSICA A (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:A
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:12213 CARMEL VISTA RD UNIT 237
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2528
Mailing Address - Country:US
Mailing Address - Phone:714-318-7751
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA35142152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist