Organization Active NPI

Jessica Huynh OD PC

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1275937955
Registry record updated Nov 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14380 Issued in CA
Legal business name
JESSICA HUYNH OD PC
Practice address
2401 15TH St
Sacramento, CA 95818-2238
Phone
(916) 443-8034
NPI assigned
Oct 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2014

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

Authorized official

Name
Dr. Jessica Huynh, ODNPI 1477866531
Title
Optometrist
Phone
(916) 335-9655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 14380 CA Primary

Addresses

Primary practice location

2401 15TH St
Sacramento, CA 95818-2238

Mailing address

1737 Diamond Woods Cir
Roseville, CA 95747-4601
Phone (916) 335-9655

Other names 1

  • Kubo Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141108000204 CA Part B Supplier - Clinic/Group Practice 4284856170 Receives reassigned benefits from 4 practitioners
Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory

Locations

2409 15th St
Sacramento, CA 95818
Phone (916) 335-9655

2401 15th St
Sacramento, CA 95818
Phone (916) 443-8034

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415404800000",
    "number": "1275937955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 DIAMOND WOODS CIR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474601",
            "telephone_number": "916-335-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 15TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958182238",
            "telephone_number": "916-443-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA HUYNH OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-11-08",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "916-335-9655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kubo Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.