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General NPI Number Information
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NPI Number | 1639751969
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Entity Type | Individual
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Provider Name | HEATHER KAPLAN-SANTOS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 30211 AVENIDA DE LAS BANDERAS, SUITE 200
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-9268
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Country | US
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Telephone | 949-409-5075
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Fax |
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Provider Business Mailing Address
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Address Line | 30211 AVENIDA DE LAS BANDERAS, SUITE 200
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688
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Country | US
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Telephone | 949-409-5075
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY32531
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY32531
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License Number State | CA
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