Provider Demographics
NPI:1437178530
Name:SANTANA, MARIA JOSI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JOSI
Last Name:SANTANA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:M
Other - Middle Name:JOSI
Other - Last Name:SANTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:632 W GIBSON RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-5169
Practice Address - Country:US
Practice Address - Phone:530-668-2600
Practice Address - Fax:530-661-0880
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17366363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00745254OtherMEDICARE RAILROAD CARRIER
CAP00745254OtherMEDICARE RAILROAD CARRIER
0PA173661Medicare PIN