Provider Demographics
NPI:1912441049
Name:SANTANA, JENNIFER A (CNA, CHHA, CRHA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SANTANA
Suffix:
Gender:F
Credentials:CNA, CHHA, CRHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11914 KLING ST APT 7
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4058
Mailing Address - Country:US
Mailing Address - Phone:818-397-2029
Mailing Address - Fax:
Practice Address - Street 1:11914 KLING ST APT 7
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-4058
Practice Address - Country:US
Practice Address - Phone:818-397-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00278922374U00000X
CA00953423376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide