Provider Demographics
NPI:1093005951
Name:SANTAMARIA, SHANNON JOY
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:JOY
Last Name:SANTAMARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 W AVENUE L4
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6949
Mailing Address - Country:US
Mailing Address - Phone:661-942-5898
Mailing Address - Fax:
Practice Address - Street 1:1624 W AVENUE L4
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6949
Practice Address - Country:US
Practice Address - Phone:661-942-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula