Individual
MRS. TERRI VACCAREZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2415 W VINE ST STE 100, LODI, CA 95242-3731
(209) 333-3135
Mailing address
2415 W VINE ST STE 100, LODI, CA 95242-3731
(209) 333-3121
(209) 333-3008
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN271511
CA
Other
Enumeration date
08/15/2006
Last updated
11/01/2011
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