Healthcare Provider Details

I. General information

NPI: 1427455427
Provider Name (Legal Business Name): ELIZABETH VACCARO RD/RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 07/07/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W CHANNEL ISLANDS BLVD
THOUSAND OAKS CA
93003
US

IV. Provider business mailing address

408 N CEDAR BLUFF RD STE 550
KNOXVILLE TN
37923-3607
US

V. Phone/Fax

Practice location:
  • Phone: 805-204-9500
  • Fax:
Mailing address:
  • Phone: 805-465-9802
  • Fax: 805-512-8522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: