Healthcare Provider Details

I. General information

NPI: 1982278701
Provider Name (Legal Business Name): SANTRO SOPHIA JEPIL RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 EUREKA WAY
REDDING CA
96001-0222
US

IV. Provider business mailing address

8721 GREENBACK LN APT 26
ORANGEVALE CA
95662-4080
US

V. Phone/Fax

Practice location:
  • Phone: 530-246-9000
  • Fax:
Mailing address:
  • Phone: 619-245-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95212534
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: