Provider Demographics
NPI:1326834193
Name:SANTACRUZ, PATRICIA V
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:V
Last Name:SANTACRUZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458-1024
Mailing Address - Country:US
Mailing Address - Phone:707-274-9101
Mailing Address - Fax:
Practice Address - Street 1:13300 E HIGHWAY 20 STE O
Practice Address - Street 2:
Practice Address - City:CLEARLAKE OAKS
Practice Address - State:CA
Practice Address - Zip Code:95423-9436
Practice Address - Country:US
Practice Address - Phone:707-998-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-MORQJN175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist