Provider Demographics
NPI:1871208827
Name:SANTIAGO, FRANCISCO SALVADOR
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:SALVADOR
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8933 PANAMA RD STE 101-103
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1633
Mailing Address - Country:US
Mailing Address - Phone:661-845-3717
Mailing Address - Fax:661-845-3385
Practice Address - Street 1:8933 PANAMA RD STE 101-103
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1633
Practice Address - Country:US
Practice Address - Phone:661-845-3717
Practice Address - Fax:661-845-3385
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA16682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator