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General NPI Number Information
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NPI Number | 1760514475
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Entity Type | Individual
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Provider Name | GLENDA LAUREN SANTOS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 2770 S MARYLAND PKWY STE 108
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City | LAS VEGAS
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State | NV
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Zip | 89109-1564
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Country | US
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Telephone | 702-463-7779
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Fax | 702-778-4226
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Provider Business Mailing Address
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Address Line | 7410 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90003-2034
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Country | US
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Telephone | 323-541-9016
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Fax | 323-541-9192
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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