Provider Demographics
NPI:1487755682
Name:STA MARIA, JOANABEL PADACA (MD)
Entity type:Individual
Prefix:DR
First Name:JOANABEL
Middle Name:PADACA
Last Name:STA MARIA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:260
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1500
Mailing Address - Country:US
Mailing Address - Phone:408-251-0835
Mailing Address - Fax:408-251-1221
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:260
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:408-251-0835
Practice Address - Fax:408-251-1221
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAA73498207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABC6143743OtherDEA NO.
CAG84227Medicare UPIN