Provider Demographics
NPI:1801017355
Name:VERNOLA, DANETTE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANETTE
Middle Name:MARIE
Last Name:VERNOLA
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 1:2439 STONY LN
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4520
Mailing Address - Country:US
Mailing Address - Phone:562-400-9644
Mailing Address - Fax:
Practice Address - Street 1:2439 STONY LN
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4520
Practice Address - Country:US
Practice Address - Phone:562-400-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor