Provider Demographics
NPI:1942934047
Name:SANTACRUZ, CLAUDIA GUADALUPE
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:GUADALUPE
Last Name:SANTACRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 GROVER AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46327-1155
Mailing Address - Country:US
Mailing Address - Phone:219-378-6235
Mailing Address - Fax:
Practice Address - Street 1:3704 GROVER AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46327-1155
Practice Address - Country:US
Practice Address - Phone:219-378-6235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program