MEDICARE: JENNIFER A SANTANA CNA, CHHA, CRHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	00278922	CA
2	376K00000X	Nurse's Aide	00953423	CA

General Provider Information

NPI Number	:	1912441049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A SANTANA CNA, CHHA, CRHA

Provider Business Mailing Address
First Line	:	11914 KLING ST APT 7
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-4058
Country	:	US
Telephone Number	:	818-397-2029
Fax Number	:

Provider Business Practice Location Address
First Line	:	11914 KLING ST APT 7
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-4058
Country	:	US
Telephone Number	:	818-397-2029
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2016
Last Update Date	:	12/08/2016

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