Provider Demographics
NPI:1821829060
Name:SANTACRUZ, EMERALD THERESE (NBC-HWC, BCHN)
Entity type:Individual
Prefix:
First Name:EMERALD
Middle Name:THERESE
Last Name:SANTACRUZ
Suffix:
Gender:F
Credentials:NBC-HWC, BCHN
Other - Prefix:
Other - First Name:EMERALD
Other - Middle Name:THERESE
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8300 MCNIE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-3609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 MCNIE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-3609
Practice Address - Country:US
Practice Address - Phone:916-541-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA-3937307OtherNATIONAL BOARD FOR HEALTH & WELLNESS COACHING ID NUMBER
CA5277OtherNATIONAL BOARD OF NUTRITION PROFESSIONALS BCHN ID #