Provider Demographics
NPI:1194957613
Name:SANTAMARIA, GERALD MARTIN (BA)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:MARTIN
Last Name:SANTAMARIA
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5128 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3422
Mailing Address - Country:US
Mailing Address - Phone:415-769-4500
Mailing Address - Fax:
Practice Address - Street 1:5128 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112
Practice Address - Country:US
Practice Address - Phone:415-769-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator