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General NPI Number Information
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NPI Number | 1477274215
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Entity Type | Individual
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Provider Name | VICTORIA VASCO FNP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1000 E DOMINGUEZ ST STE 110
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City | CARSON
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State | CA
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Zip | 90746-3615
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Country | US
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Telephone | 310-830-4561
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Fax |
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Provider Business Mailing Address
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Address Line | 926 W PALM AVE
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City | BURBANK
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State | CA
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Zip | 91506-2018
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 95020466
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 95020466
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 95020466
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95020466
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License Number State | CA
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