Provider Demographics
NPI:1992942940
Name:SANTRY, CATHY ANN (RN)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:ANN
Last Name:SANTRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 WILLOW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3025
Mailing Address - Country:US
Mailing Address - Phone:530-365-8217
Mailing Address - Fax:
Practice Address - Street 1:2165 WILLOW GLEN DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3025
Practice Address - Country:US
Practice Address - Phone:530-365-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA395266163W00000X, 163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)