Provider Demographics
NPI:1538501507
Name:STRETTON, VANESSA N (LAC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:N
Last Name:STRETTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 TRANCAS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2903
Mailing Address - Country:US
Mailing Address - Phone:707-670-7010
Mailing Address - Fax:
Practice Address - Street 1:915 TRANCAS ST
Practice Address - Street 2:SUITE B
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2903
Practice Address - Country:US
Practice Address - Phone:707-670-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14980171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist