Sergio Xavier Santos, BA, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-1627 Issued in AZ

Practice address

5501 N 19TH Ave Ste 103
Phoenix, AZ 85015

Phone

(602) 589-0500

Fax

(602) 314-4552

NPI assigned

Sep 18, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1144479718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152451",
            "telephone_number": "602-589-0500",
            "fax_number": "602-314-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85015",
            "telephone_number": "602-589-0500",
            "fax_number": "602-314-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "636 N 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850031523",
            "country_code": "US",
            "telephone_number": "602-495-3085 x1385",
            "fax_number": "602-495-3086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "SERGIO",
        "middle_name": "XAVIER",
        "name_prefix": "Mr.",
        "credential": "BA, LISAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-1627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600241392",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cedric Alen Santos
• Elaine T Santos, MD
• Jessyca Santos, RBT
• Jordan Santos, MD
• Renato M. Santos, MD
• Breanna Nicole Santoso
• Jose Alberto Santoyo, FNP
• Phil Santucci, D.D.S., M.S
• Mary Santy, M.A.,CCC-SLP
• Sanus II LLC

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.