Provider Demographics
NPI:1629882105
Name:CHAMORRO ZUNIGA, SANTIAGO (MS BCBA)
Entity type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:
Last Name:CHAMORRO ZUNIGA
Suffix:
Gender:M
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17343 GRANADA AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4926
Mailing Address - Country:US
Mailing Address - Phone:909-436-7043
Mailing Address - Fax:
Practice Address - Street 1:1801 3RD ST STE 103
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2672
Practice Address - Country:US
Practice Address - Phone:714-683-5876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-78882103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst