Provider Demographics
NPI:1013695436
Name:KAMCHAMNAN, VANESSA BRYANNE (HCA)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:BRYANNE
Last Name:KAMCHAMNAN
Suffix:
Gender:F
Credentials:HCA
Other - Prefix:MISS
Other - First Name:VANESSA
Other - Middle Name:BRYANNE
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6583 MESADA ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-4313
Mailing Address - Country:US
Mailing Address - Phone:714-463-0865
Mailing Address - Fax:
Practice Address - Street 1:1162 E 19TH ST UNIT 1120
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-4229
Practice Address - Country:US
Practice Address - Phone:619-602-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider