Individual provider Active NPI

Jennifer Ngoyen, OD

  • Optometrist
  • Inglewood, CA
National Provider Identifier
1740888627
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34703TLG Issued in CA
Practice address
3471 W Century Blvd
Inglewood, CA 90303-1218
Phone
(310) 671-1290
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34703TLG CA Primary

Addresses

Primary practice location

3471 W Century Blvd
Inglewood, CA 90303-1218

Mailing address

3309 Falcon Ave
Signal Hill, CA 90755-4811
Phone (617) 990-4433

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
I20220509002187 CA Practitioner - Optometry 6507243714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34703TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Apr 6, 2022 Accepting new patients

Locations

330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890

1055 Foothill Blvd
La Canada, CA 91011

6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1740888627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 FALCON AVE",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907554811",
            "telephone_number": "617-990-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 W CENTURY BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031218",
            "telephone_number": "310-671-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGOYEN",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34703TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.