Provider Demographics
NPI:1871725960
Name:STEENBERGEN, SELENA SHU-JEN (OD)
Entity type:Individual
Prefix:MRS
First Name:SELENA
Middle Name:SHU-JEN
Last Name:STEENBERGEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 FRINGE TREE TER
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6562
Mailing Address - Country:US
Mailing Address - Phone:408-497-5800
Mailing Address - Fax:
Practice Address - Street 1:10150 N WOLFE RD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2508
Practice Address - Country:US
Practice Address - Phone:408-446-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 13798 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist