Healthcare Provider Details

I. General information

NPI: 1184532525
Provider Name (Legal Business Name): ANGEL SANTIBANEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11075 C ST, ARMONA, CA 93202.
ARMONA CA
93202
US

IV. Provider business mailing address

2319 S ORINDA ST
FRESNO CA
93721-3416
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-5020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: