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Individual
DR. JESSICA P FANG
Active
Individual
DR. JESSICA P FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14420
CA
152WP0200X
Pediatric Optometrist
14420
CA
152WV0400X
Vision Therapy Optometrist
14420
CA
Other
Enumeration date
07/20/2012
Last updated
12/22/2021
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