Provider Demographics
NPI:1093847014
Name:VLAMYNCK, JEAN RUTH (LAC, DIPLAC,MTCM)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:RUTH
Last Name:VLAMYNCK
Suffix:
Gender:F
Credentials:LAC, DIPLAC,MTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1343
Mailing Address - Country:US
Mailing Address - Phone:831-426-4299
Mailing Address - Fax:831-426-4299
Practice Address - Street 1:726 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1343
Practice Address - Country:US
Practice Address - Phone:831-426-4299
Practice Address - Fax:831-426-4299
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4389171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist