Provider Demographics
NPI:1366893927
Name:SANTOS, ROLANDO MARCELLA JR (FNP)
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:MARCELLA
Last Name:SANTOS
Suffix:JR
Gender:M
Credentials:FNP
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Mailing Address - Street 1:729 SUNRISE AVE STE 611
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4548
Mailing Address - Country:US
Mailing Address - Phone:916-953-7571
Mailing Address - Fax:916-771-8515
Practice Address - Street 1:650 HOWE AVE STE 600
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4797
Practice Address - Country:US
Practice Address - Phone:916-953-7571
Practice Address - Fax:916-771-8515
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2020-06-24
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Provider Licenses
StateLicense IDTaxonomies
CA95004444363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily