DR. JENIFER KENI KEIKO ISHIZAKI CHUNG (NPI# 1821140534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821140534 |
| Entity Type | Individual |
| Full Name | DR. JENIFER KENI KEIKO ISHIZAKI CHUNG |
| Credential | O.D. |
| Practice Address |
3400 Delta Fair Blvd Eyecare Clinic-optometry Antioch CA 94509-4004 |
| Mailing Address |
4501 Sandcreek Road Eyecare Clinic- Optometry Antioch CA 94531 |
| Practice Telephone | 9257794378 |
| Practice Fax Number | 9257795421 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 550 | HI | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 11660 | CA | Eye and Vision Services Providers |
| Street Address |
3400 DELTA FAIR BLVD EYECARE CLINIC-OPTOMETRY |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929914 | Barbara A Rhoades | Nurse Practitioner | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2005-08-18 |
| 1962936849 | Nardip Singh | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-17 |
| 1649704743 | Anh X Nguyen | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-14 |
| 1104359918 | Borey Som | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-07 |
| 1790005015 | Elizabeth Seidler | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2010-06-09 |
| 1699091793 | Allison Townsend Hampton | Pediatrics | 3400 Delta Fair Blvd, Department of Pediatrics, Antioch, CA 94509-4004 | 2010-04-14 |
| 1063746998 | Athena Panzar | Counselor | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2009-09-24 |
| 1083859888 | Philip Song | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2008-12-08 |
| 1033319215 | Sanaz Stacy Aboutalebi-simon | Optometrist | 3400 Delta Fair Blvd, The Permanente Medical Group, Inc., Antioch, CA 94509-4004 | 2007-07-24 |
| 1700099264 | Derek S Mongold | Family Medicine | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2007-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770130932 | Winson Ong Od | Optometrist | 5109 Lone Tree Way, Antioch, CA 94531-8484 | 2019-08-22 |
| 1053727099 | Katelyn Shea | Optometrist | 5323 Mt View Rd, Antioch, TN 37013-2805 | 2014-07-10 |
| 1154569234 | Family Optometric Vision Care | Optometrist | 5163 Lone Tree Way, Antioch, CA 94531-8689 | 2009-01-28 |
| 1760670624 | Balfour Vision Optix Optometry Inc. | Optometrist | 5113 Lone Tree Way, Antioch, CA 94531-8484 | 2007-10-04 |
| 1225241219 | Eileen M Linder Optometrist Inc | Optometrist | 4051 Lone Tree Way Ste E, Antioch, CA 94531-6204 | 2007-05-07 |
| 1205954716 | Roger Allen Sona | Optometrist | 735 Main St, Antioch, IL 60002-1321 | 2007-03-26 |
| 1407987001 | Lone Tree Optometry, Inc. | Optometrist | 5113 Lone Tree Wy, Antioch, CA 94531-8484 | 2007-03-08 |
| 1942344197 | Frances V Ong | Optometrist | 3747 Sunset Ln, Antioch, CA 94509-6101 | 2007-02-19 |
| 1366584302 | Eileen Marie Linder | Optometrist | 4051 Lone Tree Way, Suite E, Antioch, CA 94531-6204 | 2007-02-13 |
| 1083779854 | Robert Hohn | Optometrist | 5304-j Mt. View Road, Antioch, TN 37013 | 2006-12-22 |
| Find all providers in ANTIOCH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.