Provider Demographics
NPI:1194050542
Name:SANTOS, MARIE L (CD)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:L
Last Name:SANTOS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 GLORIA AVE
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-3565
Mailing Address - Country:US
Mailing Address - Phone:619-254-9716
Mailing Address - Fax:
Practice Address - Street 1:611 GLORIA AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-3565
Practice Address - Country:US
Practice Address - Phone:619-254-9716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula