Provider Demographics
NPI:1417751827
Name:SANTOS, ROWENA E (RN)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:E
Last Name:SANTOS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 LILAC AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-3829
Mailing Address - Country:US
Mailing Address - Phone:619-701-5682
Mailing Address - Fax:
Practice Address - Street 1:1384 LILAC AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3829
Practice Address - Country:US
Practice Address - Phone:619-701-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA518164163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse