Provider Demographics
NPI:1366009730
Name:SANTOS, OLGA EDITH (LCSW)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:EDITH
Last Name:SANTOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:CARMONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 SENITA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-8060
Mailing Address - Country:US
Mailing Address - Phone:858-213-8782
Mailing Address - Fax:
Practice Address - Street 1:2116 SENITA DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-8060
Practice Address - Country:US
Practice Address - Phone:858-213-8782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1297891041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health