Susanna Santos

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

21556 Issued in CA

Practice address

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Phone

(858) 859-1188

NPI assigned

Oct 15, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1679725139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "SUSANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "AP2631",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "AP2631",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "21556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogelio Jonathan Santos
• Ronnie Cajes Santos Jr.
• Sandra Isabel Santos, OTR/L, CLT
• Shianne Vargas Santos
• Suely Suzana Santos
• Thuy Vo Santos, MFT
• Tracy Fullenwider Santos, DO
• Agnes C Santosa, M.D.
• Jessica Christabella Santoso, PHARMD
• Joaquin Santoy, MD

• Medical Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.