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General NPI Number Information
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NPI Number | 1811143753
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Entity Type | Individual
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Provider Name | RENEE MICHELLE SANTOS LMHC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 4660 VIEWRIDGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-1638
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Country | US
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Telephone | 619-277-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 2561 RAYMELL DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-3543
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Country | US
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Telephone | 508-745-9362
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10467
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7901
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License Number State | CA
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