Individual
DANIELLA THEODORA VIVANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30332 ESPERANZA, RANCHO SANTA MARGARITA, CA 92688-2118
(949) 264-6440
Mailing address
20 BLUEJAY, IRVINE, CA 92604-3266
(949) 648-9853
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC36629
CA
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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