=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598566309
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALENCIA CHIROPRACTIC TRAPASSO INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2025
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25060 AVENUE STANFORD
-----------------------------------------------------
City | VALENCIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91355-3411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-491-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25060 AVENUE STANFORD STE 290
-----------------------------------------------------
City | VALENCIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91355-0984
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-491-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. JACK TRAPASSO
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 661-941-1900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NS0005X
-----------------------------------------------------
Taxonomy Name | Sports Physician Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------