Jennifer Baek, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35051 Issued in CA

Practice address

1320 Broadway PLZ
Walnut Creek, CA 94596-5129

Phone

(925) 939-3591

NPI assigned

Oct 20, 2021

Last updated

Oct 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1174286637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 PARKER ST UNIT 201",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 BROADWAY PLZ",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965129",
            "telephone_number": "925-939-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEK",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.