Individual provider Active NPI

Rene Osorio Santiago

  • Addiction (Substance Use Disorder) Counselor
  • Fullerton, CA
National Provider Identifier
1295240463
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
01312281705 Issued in CA
Practice address
1060 S Brookhurst Rd
Fullerton, CA 92833-3709
Phone
(562) 623-8569
NPI assigned
Dec 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 01312281705 CA Primary

Addresses

Primary practice location

1060 S Brookhurst Rd
Fullerton, CA 92833-3709

Mailing address

1060 S Brookhurst Rd
Fullerton, CA 92833-3709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01312281705CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1295240463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 S BROOKHURST RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S BROOKHURST RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333709",
            "telephone_number": "562-623-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO SANTIAGO",
        "first_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "01312281705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.