Healthcare Provider Details

I. General information

NPI: 1952926438
Provider Name (Legal Business Name): PERLA ZULIANA SANTIAGO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PERLA ZULIANA AGUAYO VAZQUEZ FNP

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 JOHN JONES RD
DAVIS CA
95616-9701
US

IV. Provider business mailing address

2051 JOHN JONES RD
DAVIS CA
95616-9701
US

V. Phone/Fax

Practice location:
  • Phone: 530-758-2060
  • Fax: 530-758-8490
Mailing address:
  • Phone: 530-758-2060
  • Fax: 530-758-8490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: