Santiago Canyon College

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

Z0A8350 Issued in CA

Legal business name

SANTIAGO CANYON COLLEGE

Practice address

8045 East Chapman Ave
Building T - 102 Student Health
Orange, CA 92869-4773

Phone

(714) 628-4773

Fax

(714) 628-4749

NPI assigned

Jan 19, 2012

Organization subpart

Yes

Parent organization

SANTIAGO CANYON COLLEGE STUDENT HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Renee E. Yocam, MD, DO

Title

College Physician

Phone

(714) 628-4773

Specialties & licenses 3

Addresses

Other names 1

• Student Health and Wellness Center Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Santa Ana College2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Santa Ana College

  • Student Health Clinic/Center
  • Santa Ana, CA
  • NPI 1861829061
  NPD tax ID

Locations

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1386915593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 EAST CHAPMAN AVE",
            "address_2": "BUILDING T - 102 STUDENT HEALTH",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928694773",
            "telephone_number": "714-628-4773",
            "fax_number": "714-628-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 EAST CHAPMAN AVE",
            "address_2": "BUILDING T - 102 STUDENT HEALTH",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928694773",
            "telephone_number": "714-628-4773",
            "fax_number": "714-628-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAGO CANYON COLLEGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTIAGO CANYON COLLEGE STUDENT HEALTH CENTER",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "YOCAM",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "COLLEGE PHYSICIAN",
        "authorized_official_telephone_number": "714-628-4773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DO"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY20612",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "B307289",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "Z0A8350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Health and Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Michelle Santana, LCSW
• Michelle Santana
• Rosie Santana
• Katherine Santander
• Kathlyn Santeros
• Santiago Charter Middle School
• Brisa Santiago Ixta
• Kathryn Lysette Santiago Ocampo
• Latevia Quintetta R Santiago Porter
• Adam Joshua Santiago

• Adult Medicine Physician in Orange, CA
• Providers in Orange, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.