Provider Demographics
NPI:1144077165
Name:RENTERIA SANTANA, CLAUDIA L (LMT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:L
Last Name:RENTERIA SANTANA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 FROSTWOOD TER
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-1805
Mailing Address - Country:US
Mailing Address - Phone:405-727-0734
Mailing Address - Fax:
Practice Address - Street 1:13316 S WESTERN AVE STE J
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7309
Practice Address - Country:US
Practice Address - Phone:405-548-5693
Practice Address - Fax:214-975-2896
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK167174225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist