Healthcare Provider Details

I. General information

NPI: 1487276218
Provider Name (Legal Business Name): BETZABEL MARIN SANTAMARIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W 1ST ST STE 102
SANTA ANA CA
92701-5262
US

IV. Provider business mailing address

12712 MERRILL ST
GARDEN GROVE CA
92840-5742
US

V. Phone/Fax

Practice location:
  • Phone: 714-972-4921
  • Fax:
Mailing address:
  • Phone: 714-583-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95025457
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95205501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: