Provider Demographics
NPI:1104258052
Name:SANTANA SAMER, MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SANTANA SAMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:SANTANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2451
Mailing Address - Country:US
Mailing Address - Phone:451-625-5055
Mailing Address - Fax:
Practice Address - Street 1:2 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2451
Practice Address - Country:US
Practice Address - Phone:451-625-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12867225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist