| Doctor Name: | MS. JENNIFER H TRUONG |
| NPI Number: | 1003237835 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ABOC |
| License Number: | 183247 |
| Business Practice Address: | 11421 Carson St Ste D Lakewood, CA - 907152500 |
| Business Phone Number: | 5628604590 |
| Business Fax Number: | |
| Mailing Address: | 11421 Carson St Ste D, LAKEWOOD |
| State: | CA |
| Postal Code: | 907152500 |
| Phone Number: | 5628604590 |
| Fax Number: | |
| NPI Enumeration Date: | 12/20/2013 |
| NPI Last Update Date: | 12/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 183247 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |