Larry Boado Santiago

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

96681 Issued in CA

Practice address

2086 Commerce Ave
Concord, CA 94520-4902

Phone

(925) 827-0212

Fax

(925) 827-1122

NPI assigned

Nov 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1518149889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 DIAMOND HEIGHTS BLVD APT 105A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311747",
            "telephone_number": "925-331-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 COMMERCE AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204902",
            "telephone_number": "925-827-0212",
            "fax_number": "925-827-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "LARRY",
        "middle_name": "BOADO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "96681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITYBEHAVIORALHEALTH",
            "identifier": "1922162999",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marina Santiago-Chavez
• Bryan Santiago
• Jayleena Marie Santiago
• Joel Santiago
• Lady Cecilia Santiago
• Fernanda Santillan Morales
• Odalys Estefania Santillan
• Giselle Elysia Santolaya
• Veronica Santos Avalos
• Lucas Aikiuri Santos Silva

• Marriage & Family Therapist in Concord, CA
• Providers in Concord, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.