Provider Demographics
NPI:1699294389
Name:SANTILLANA, JELEENA BRITTANI CASQUEJO (MHS, PA-C)
Entity type:Individual
Prefix:
First Name:JELEENA
Middle Name:BRITTANI CASQUEJO
Last Name:SANTILLANA
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 KATELLA AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3386
Mailing Address - Country:US
Mailing Address - Phone:562-430-6065
Mailing Address - Fax:562-430-6069
Practice Address - Street 1:3801 KATELLA AVE STE 414
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3386
Practice Address - Country:US
Practice Address - Phone:562-430-6065
Practice Address - Fax:562-430-6069
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA54828363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant