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Provider Information for 1477588119


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DORIS SANTIAGO LMFT


Sex: Female

NPI: 1477588119
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1477588119
Enumeration Date2006-07-11
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 375 E LINE ST
BISHOP, CA 93514-3566
United States

Phone: 760-873-4357 | Fax:760-873-7446
 
Primary Practice Address 375 E LINE ST
BISHOP, CA 93514-3566
United States

Phone: 760-873-4357 | Fax:760-873-7446
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist CAMFC34526