Individual provider Active NPI

Jessica A Tran, OD

  • Optometrist
  • San Diego, CA
National Provider Identifier
1457922957
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35142 Issued in CA
Practice address
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone
(858) 552-8585
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35142 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
San Diego, CA 92161-0002

Mailing address

12213 Carmel Vista Rd Unit 237
San Diego, CA 92130-2528
Phone (714) 318-7751

Other practice location 1

1000 Vale Terrace Dr
Vista, CA 92084-5218
Phone (760) 631-5000

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
I20230912003427 CA Order and Referring Only - OptometryPractitioner - Optometry 7214391093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35142CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Regency Eye Care, Inc. Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1457922957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12213 CARMEL VISTA RD UNIT 237",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302528",
            "telephone_number": "714-318-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Vale Terrace Dr",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920845218",
            "country_code": "US",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.