Healthcare Provider Details

I. General information

NPI: 1144172446
Provider Name (Legal Business Name): ARMANDO SANTIAGO NEGRETE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 BLOSSOM HILL RD STE 201
SAN JOSE CA
95123-1655
US

IV. Provider business mailing address

996 ROYAL MARCO WAY
MARCO ISLAND FL
34145-1829
US

V. Phone/Fax

Practice location:
  • Phone: 408-423-8076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: