Provider Demographics
NPI:1982397980
Name:SAUCEDO, SANTINA SHARI
Entity Type:Individual
Prefix:MISS
First Name:SANTINA
Middle Name:SHARI
Last Name:SAUCEDO
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 1:1265 FURUKAWA WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-4929
Mailing Address - Country:US
Mailing Address - Phone:805-614-4940
Mailing Address - Fax:
Practice Address - Street 1:1265 FURUKAWA WAY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4929
Practice Address - Country:US
Practice Address - Phone:805-614-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker