Provider Demographics
NPI:1598843062
Name:VODON, VICTORIA MARIE (DC)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:MARIE
Last Name:VODON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3400 IRVINE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3127
Mailing Address - Country:US
Mailing Address - Phone:714-658-3112
Mailing Address - Fax:949-688-6806
Practice Address - Street 1:3400 IRVINE AVE STE 109
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3127
Practice Address - Country:US
Practice Address - Phone:714-658-3112
Practice Address - Fax:949-688-6806
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA14795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor