MEDICARE: COLLEEN SANTOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT298582	CA

General Provider Information

NPI Number	:	1780299313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN SANTOS

Provider Business Mailing Address
First Line	:	39120 ARGONAUT WAY STE 274
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1304
Country	:	US
Telephone Number	:	510-745-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 EMPEY WAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4705
Country	:	US
Telephone Number	:	408-275-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	07/19/2022

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Directions to “ COLLEEN SANTOS ” Practice Location

Language	Start Address	Practice Location

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