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NPI Code Detail

MEDICARE: ABIGAIL GRICELDA SANTILLAN

MEDICARE: ABIGAIL GRICELDA SANTILLAN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417891615
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL GRICELDA SANTILLAN
Provider Business Mailing Address
First Line : 84508 CORTE CINDARELLA
Second Line :
City : COACHELLA
State : CA
Zip : 92236-3381
Country : US
Telephone Number : 442-215-6003
Fax Number :
Provider Business Practice Location Address
First Line : 11799 SEBASTIAN WAY STE 103
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-0708
Country : US
Telephone Number : 909-353-7547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “ ABIGAIL GRICELDA SANTILLAN ” Practice Location

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