MEDICARE: ERICK SANTOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator
3	225400000X	Rehabilitation Practitioner
4	1041C0700X	Clinical Social Worker	95340	CA

General Provider Information

NPI Number	:	1225450463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICK SANTOS

Provider Business Mailing Address
First Line	:	10210 ORR AND DAY RD STE B
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3581
Country	:	US
Telephone Number	:	562-270-5247
Fax Number	:

Provider Business Practice Location Address
First Line	:	10210 ORR AND DAY RD STE B
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3581
Country	:	US
Telephone Number	:	562-270-5247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2014
Last Update Date	:	09/28/2020

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Directions to “ ERICK SANTOS ” Practice Location

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