Healthcare Provider Details

I. General information

NPI: 1811848294
Provider Name (Legal Business Name): SARA MARIE SANTANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1748 E 1ST ST UNIT 303
LONG BEACH CA
90802-5992
US

IV. Provider business mailing address

2201 N LAKEWOOD BLVD STE D PMB 164
LONG BEACH CA
90815
US

V. Phone/Fax

Practice location:
  • Phone: 562-881-6970
  • Fax:
Mailing address:
  • Phone: 562-881-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW102612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: