Provider Demographics
NPI:1548421118
Name:VACCARO, JENNIFER MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:VACCARO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18352 SOLEDAD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3035
Mailing Address - Country:US
Mailing Address - Phone:661-298-2700
Mailing Address - Fax:661-298-2772
Practice Address - Street 1:18352 SOLEDAD CANYON ROAD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387
Practice Address - Country:US
Practice Address - Phone:661-298-2700
Practice Address - Fax:661-412-0233
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30878111N00000X, 111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist