| Doctor Name: | MS. CONSTANCE MARIE VACCAREZZA |
| NPI Number: | 1801078340 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHN |
| License Number: | 384667 |
| Business Practice Address: | 6421 S Burson Rd Valley Springs, CA - 952528909 |
| Business Phone Number: | 2097723192 |
| Business Fax Number: | |
| Mailing Address: | 6421 S Burson Rd, VALLEY SPRINGS |
| State: | CA |
| Postal Code: | 952528909 |
| Phone Number: | 2097723192 |
| Fax Number: | |
| NPI Enumeration Date: | 11/27/2007 |
| NPI Last Update Date: | 11/27/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 384667 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |