Provider Demographics
NPI:1659848950
Name:SANTA MARIA, SUE-JEAN (MS, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUE-JEAN
Middle Name:
Last Name:SANTA MARIA
Suffix:
Gender:F
Credentials:MS, FNP-C
Other - Prefix:MS
Other - First Name:SUE-JEAN
Other - Middle Name:
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,FNP-C
Mailing Address - Street 1:185 BERRY ST LOBBY 2, SUITE 130
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-5705
Mailing Address - Country:US
Mailing Address - Phone:415-514-4533
Mailing Address - Fax:
Practice Address - Street 1:185 BERRY ST LOBBY 2, SUITE 130
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5705
Practice Address - Country:US
Practice Address - Phone:415-514-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009853363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily