Provider Demographics
NPI:1619634847
Name:SANCHEZ SANTIESTEBAN, MELISA A (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:A
Last Name:SANCHEZ SANTIESTEBAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 W PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1555
Mailing Address - Country:US
Mailing Address - Phone:818-452-1279
Mailing Address - Fax:
Practice Address - Street 1:3413 W PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1555
Practice Address - Country:US
Practice Address - Phone:818-452-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant