Provider Demographics
NPI:1073091625
Name:VACCARO, RACHEL ANN (ATC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:VACCARO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 HERVEY LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-1849
Mailing Address - Country:US
Mailing Address - Phone:201-874-7758
Mailing Address - Fax:
Practice Address - Street 1:1539 HERVEY LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-1849
Practice Address - Country:US
Practice Address - Phone:201-874-7758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-04
Last Update Date:2018-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer