MS. Jennifer L Vivanco, RPT

NPI #1982767596 in Porter Ranch, California

Provider Information

NPI Number: 1982767596
Entity Type: Individual
Name: MS. Jennifer L Vivanco, RPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: RPT
Enumeration Date: Dec 18, 2006
Last Updated: Feb 24, 2020

Practice Location

Address: 11239 TAMPA AVE STE 205
City: Porter Ranch
State: California
ZIP Code: 91326-3782
Phone: (818) 831-0484

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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