Provider Demographics
NPI:1700878055
Name:ONG, JENNIFER H (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:ONG
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2223 SANTA CLARA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4469
Mailing Address - Country:US
Mailing Address - Phone:510-521-0551
Mailing Address - Fax:510-864-0100
Practice Address - Street 1:2223 SANTA CLARA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4469
Practice Address - Country:US
Practice Address - Phone:510-521-0551
Practice Address - Fax:510-864-0100
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2015-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT10520T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist