Provider Demographics
NPI:1376429399
Name:CONNER, MATALIA SANTAHJIA (PMHNP)
Entity type:Individual
Prefix:
First Name:MATALIA
Middle Name:SANTAHJIA
Last Name:CONNER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 KING RICHARDS WAY
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-4991
Mailing Address - Country:US
Mailing Address - Phone:334-832-0429
Mailing Address - Fax:
Practice Address - Street 1:120 KING RICHARDS WAY
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-4991
Practice Address - Country:US
Practice Address - Phone:334-832-0429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-184832163W00000X
AL2024105932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse