Healthcare Provider Details

I. General information

NPI: 1306778287
Provider Name (Legal Business Name): PAOLA ITZEL BARRON SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 36TH AVE
OAKLAND CA
94601-3572
US

IV. Provider business mailing address

1451 36TH AVE
OAKLAND CA
94601-3572
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-8391
  • Fax:
Mailing address:
  • Phone: 424-522-8391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: