Provider Demographics
NPI:1023268794
Name:SANTIAGO, JAMES F (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S. ENCINITAS AVE.
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016
Mailing Address - Country:US
Mailing Address - Phone:626-483-0246
Mailing Address - Fax:626-357-6306
Practice Address - Street 1:134 S ENCINITAS AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2830
Practice Address - Country:US
Practice Address - Phone:626-483-0246
Practice Address - Fax:626-357-6306
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist