MEDICARE: ANGELICA SANTIAGO

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1235944026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA SANTIAGO

Provider Business Mailing Address
First Line	:	30596 MILANO RD
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92591-1933
Country	:	US
Telephone Number	:	951-294-8305
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 OCEANSIDE BLVD STE T
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-5821
Country	:	US
Telephone Number	:	949-474-1493
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	12/09/2025

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Directions to “ ANGELICA SANTIAGO ” Practice Location

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