Provider Demographics
NPI:1467150383
Name:ACENCIO, ZACHARY JOHN (DC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOHN
Last Name:ACENCIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 BRIMHALL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2786
Mailing Address - Country:US
Mailing Address - Phone:559-791-5084
Mailing Address - Fax:
Practice Address - Street 1:9730 BRIMHALL RD STE 3
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2786
Practice Address - Country:US
Practice Address - Phone:559-791-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor