Individual provider Active NPI

Jennifer J Che, O.D

  • Optometrist
  • San Pedro, CA
National Provider Identifier
1013205905
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14336 Issued in CA
Practice address
625 W 9TH St
San Pedro, CA 90731-3107
Phone
(310) 833-2495
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14336 CA Primary
Low Vision Rehabilitation Optometrist 152WL0500X 14336 CA
Optometrist 152W00000X 8021476-9934 UT

Addresses

Primary practice location

625 W 9TH St
San Pedro, CA 90731-3107

Mailing address

300 Tejon PL Unit 5
Palos Verdes Estates, CA 90274-1204
Phone (310) 591-8668

Other practice location 1

300 Tejon Pl Unit 5
Palos Verdes Estates, CA 90274-1204
Phone (310) 591-8668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131206000561 CA Practitioner - Optometry 3072740646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

625 W 9TH St
San Pedro, CA 90731-3107
Phone (310) 833-2495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14336CAMDOptometrist
8021476-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Optometry Inc Optometrist CurrentSince May 1, 2026 Accepting new patients
Jennifer Che O D a Professional Corporation CurrentSince Mar 12, 2018 Accepting new patients

Locations

300 Tejon Pl
#5
Palos Verdes Estates, CA 90274
Phone (310) 377-1198

625 W 9th St
San Pedro, CA 90731
Phone (310) 833-2495

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1013205905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TEJON PL UNIT 5",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "902741204",
            "telephone_number": "310-591-8668",
            "fax_number": "310-591-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313107",
            "telephone_number": "310-833-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Tejon Pl Unit 5",
            "address_purpose": "LOCATION",
            "city": "Palos Verdes Estates",
            "state": "CA",
            "postal_code": "902741204",
            "country_code": "US",
            "telephone_number": "310-591-8668",
            "fax_number": "310-591-8678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHE",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14336",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "14336",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "8021476-9934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.