Individual provider Active NPI

Jenny Yen, O.D.

  • Optometrist
  • Cupertino, CA
National Provider Identifier
1992847925
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11986T Issued in CA
Practice address
10123 N Wolfe Rd Ste 2009
Cupertino, CA 95014-2535
Phone
(408) 255-8100
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11986T CA Primary

Addresses

Primary practice location

10123 N Wolfe Rd Ste 2009
Cupertino, CA 95014-2535

Mailing address

4207 Hamilton Ave
San Jose, CA 95130-1462

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
I20040611001014 CA Practitioner - Optometry 0345223061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3126 Professional Dr
Suite 300
Auburn, CA 95603-2412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11986TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Aug 30, 2021 Accepting new patients
Foreman Eye Care, Inc. Optometrist CurrentSince Jan 1, 2024 Accepting new patients
Exotique Vision Past Accepting new patients
Arthur Friedman OD a Professional Optometric Corporation Optometrist PastSince Aug 23, 2004 Accepting new patients

Locations

3126 Professional Dr
Ste 300
Auburn, CA 95603
Phone (530) 885-3767

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 6

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992847925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 HAMILTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951301462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 N WOLFE RD STE 2009",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142535",
            "telephone_number": "408-255-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEN",
        "first_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11986T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.