Jacqueline Truong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

11766TLG Issued in CA

Practice address

15070 Summit Ave Ste 400
Fontana, CA 92336-5387

Phone

(909) 463-4655

Fax

(909) 463-9655

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Inland Optometric Associates

  • Optometrist
  • Fontana, CA
  • NPI 1497960181
  NPD (past) Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1205994050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15070 SUMMIT AVE",
            "address_2": "SUITE 400",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365387",
            "telephone_number": "909-463-4655",
            "fax_number": "909-463-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15070 SUMMIT AVE STE 400",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365387",
            "telephone_number": "909-463-4655",
            "fax_number": "909-463-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11766T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11766TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9425438",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Trotter
• Truhearts Support Services LLC
• Daisy Trujillo Garcia
• Michael James Trujillo, M.D.
• Hoan-Vu Truong, DMD
• Jerome Tsai, MD
• Pauline B. Tsai, MD
• Betty W Tseng, PHARMD
• Lawrence Wei Tseng, OD
• Faith Mary Tsou, RN

• Optometrist in Fontana, CA
• Providers in Fontana, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.