Healthcare Provider Details

I. General information

NPI: 1013843556
Provider Name (Legal Business Name): JOYCE SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 G ST
SACRAMENTO CA
95814-1212
US

IV. Provider business mailing address

3955 COLLINS ST
WEST SACRAMENTO CA
95691-5475
US

V. Phone/Fax

Practice location:
  • Phone: 916-336-1563
  • Fax:
Mailing address:
  • Phone: 916-336-1563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW136665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: