Provider Demographics
NPI:1497404750
Name:VANZANT, TRONICA (DTCM, LAC)
Entity Type:Individual
Prefix:DR
First Name:TRONICA
Middle Name:
Last Name:VANZANT
Suffix:
Gender:F
Credentials:DTCM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5856 EL DORI DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2502
Mailing Address - Country:US
Mailing Address - Phone:408-300-3792
Mailing Address - Fax:
Practice Address - Street 1:1836 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5631
Practice Address - Country:US
Practice Address - Phone:408-300-3792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18930171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty