MEDICARE: MISS ANGELA 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1750425336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANGELA SANTIAGO

Provider Business Mailing Address
First Line	:	9190 WILLOWBERRY WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-8044
Country	:	US
Telephone Number	:	916-683-0777
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 47TH AVE STE 300
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95824-3946
Country	:	US
Telephone Number	:	916-391-6694
Fax Number	:

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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Directions to “ MISS ANGELA SANTIAGO ” Practice Location

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