Provider Demographics
NPI:1306399787
Name:SANTANA, DELIA (PHD, RN, MSN MPH)
Entity Type:Individual
Prefix:DR
First Name:DELIA
Middle Name:
Last Name:SANTANA
Suffix:
Gender:F
Credentials:PHD, RN, MSN MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W MANCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1753
Mailing Address - Country:US
Mailing Address - Phone:310-419-6702
Mailing Address - Fax:
Practice Address - Street 1:123 W MANCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1753
Practice Address - Country:US
Practice Address - Phone:310-419-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN544447163WC0400X, 163WC1500X, 163WI0600X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator