Provider Demographics
NPI:1215701305
Name:VAN SANTEN, PATRICIA (LAC DAOM)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:VAN SANTEN
Suffix:
Gender:F
Credentials:LAC DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74275 COVERED WAGON TRL
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5608
Mailing Address - Country:US
Mailing Address - Phone:310-766-1920
Mailing Address - Fax:
Practice Address - Street 1:73345 HIGHWAY 111 STE 101
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3909
Practice Address - Country:US
Practice Address - Phone:760-773-4948
Practice Address - Fax:760-773-4910
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA5436171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist