Provider Demographics
NPI:1760619449
Name:VANMETER, JILL (LAC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:
Last Name:VANMETER
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 1:1811 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1975
Mailing Address - Country:US
Mailing Address - Phone:760-522-6842
Mailing Address - Fax:
Practice Address - Street 1:1811 LINWOOD ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-1975
Practice Address - Country:US
Practice Address - Phone:760-522-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5463171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist