Provider Demographics
NPI:1053007153
Name:HOANG, JESSICA MY (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MY
Last Name:HOANG
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:5820 STONERIDGE MALL RD STE 114
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3275
Mailing Address - Country:US
Mailing Address - Phone:925-784-5210
Mailing Address - Fax:
Practice Address - Street 1:5820 STONERIDGE MALL RD STE 114
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3275
Practice Address - Country:US
Practice Address - Phone:925-421-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY009716152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist