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General NPI Number Information
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NPI Number | 1457098824
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Entity Type | Individual
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Provider Name | HECTOR FRANCISCO DE LOS SANTOS
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Gender | Male
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 20377 SW ACACIA ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0780
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Country | US
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Telephone | 949-237-2806
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SAINT JOSEPH AVE APT D
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City | LONG BEACH
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State | CA
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Zip | 90803-3179
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Country | US
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Telephone | 949-293-8198
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 32690
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License Number State | CA
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