Healthcare Provider Details

I. General information

NPI: 1760745038
Provider Name (Legal Business Name): SIENNA VICTORIA TITEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SOQUEL DR STE 1
SANTA CRUZ CA
95065-1716
US

IV. Provider business mailing address

1510 CAPITOLA RD
SANTA CRUZ CA
95062-2912
US

V. Phone/Fax

Practice location:
  • Phone: 831-465-5440
  • Fax: 831-462-2017
Mailing address:
  • Phone: 831-427-3500
  • Fax: 831-457-2486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA128806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: