Active NPI
Jessica Duong, O.D.
- Corneal and Contact Management Optometrist
- Riverside, CA
National Provider Identifier
1750679171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 14233
- Practice address
- 4294 Riverwalk Pkwy
Suite 204
Riverside, CA 92505-8508 - Phone
- (909) 225-7499
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14233TLG | CA | |
| Corneal and Contact Management Optometrist | 152WC0802X | 14233 | CA | Primary |
| Pediatric Optometrist | 152WP0200X | 14233TLG | CA | |
| Sports Vision Optometrist | 152WS0006X | 14233TLG | CA | |
| Occupational Vision Optometrist | 152WX0102X | 14233TLG | CA |
Addresses
Primary practice location
4294 Riverwalk Pkwy
Suite 204
Riverside, CA 92505-8508
Mailing address
4294 Riverwalk Pkwy
Suite 204
Riverside, CA 92505-8508
Phone (909) 225-7499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14233TLG | CA | MD | Sports Vision Optometrist |
| 14233 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1750679171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4294 RIVERWALK PKWY",
"address_2": "SUITE 204",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925058508",
"telephone_number": "909-225-7499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4294 RIVERWALK PKWY",
"address_2": "SUITE 204",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925058508",
"telephone_number": "909-225-7499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUONG",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14233TLG",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "14233",
"primary": true
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "CA",
"license": "14233TLG",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "CA",
"license": "14233TLG",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "CA",
"license": "14233TLG",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.