Provider Demographics
NPI:1447085113
Name:MANFREDI, VANESSA (DC)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:MANFREDI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41969 MARGARITA RD APT 40
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-2817
Mailing Address - Country:US
Mailing Address - Phone:818-512-2507
Mailing Address - Fax:
Practice Address - Street 1:945 S MISSION RD
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3202
Practice Address - Country:US
Practice Address - Phone:760-723-9512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37062111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician