Provider Demographics
NPI:1407083116
Name:SANTIAGO, DANIELLE ALISON (NP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALISON
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CREEKSIDE DR
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3444
Mailing Address - Country:US
Mailing Address - Phone:916-984-8244
Mailing Address - Fax:
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 1400
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-984-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652839163W00000X
CA18963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse