Shayane Valenzuela Santiago, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

846/848 Gravenstein Hwy S.
Sebastopol, CA 95472

Phone

(323) 403-7476

NPI assigned

Jun 1, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1003308313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 GRAVENSTEIN HIGHWAY SOUTH",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846/848 GRAVENSTEIN HWY S.",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "323-403-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "SHAYANE",
        "middle_name": "VALENZUELA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "1003308313",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Sebastopol",
            "affiliation": "N",
            "address_1": "846/848 Gravenstein HWY S.",
            "city": "Sebastopol",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Safeway Inc
• Elizabeth Tucker Sailer, L.AC.
• Nancy Salman
• Trista Jean Samole, M.S.
• Sandhya Inc.
• Stacey J Santiago
• Rebecca Sarino, AMFT
• Loie Goldfield Sauer, M.D.
• Areen Sawaged
• Richard Schechter, DC

• Athletic Trainer in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.