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General NPI Number Information
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NPI Number | 1356819031
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Entity Type | Organization
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Legal Business Name | ROSANNA SANTOS MARRIAGE AND FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 11/11/2018
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Last Update Date | 11/11/2018
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Provider Practice Location Address
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Address Line | 275 E HILLCREST DR STE 140
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7770
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Country | US
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Telephone | 805-501-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 275 E HILLCREST DR STE 140
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7770
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Country | US
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Telephone | 805-501-4775
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSANNA MAE SANTOS
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Credential | MA, MFT, LPCC
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Telephone | 805-501-4775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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