Mariela De Santiago

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

260225 Issued in CA

Practice address

62 Orient St
Fillmore, CA 93015-1871

Phone

(805) 990-3745

NPI assigned

Dec 10, 2014

Last updated

Dec 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1558769398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ORIENT ST",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ORIENT ST",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151871",
            "telephone_number": "805-990-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SANTIAGO",
        "first_name": "MARIELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "260225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Corral, PPC
• County of Ventura (VCBH - Fillmore Substance Use Services)
• County of Ventura (Fillmore Family Medical Group FQHC)
• County of Ventura (VCBH - Fillmore Youth & Family Mental Health)
• Ryan A Davis
• Edna Ann Dean, PA-C
• Empower Bright Minds Psychology
• Epiphany Care Homes Inc (Rural Haven Home ICF/DD-H)
• Epiphany Care Homes Inc (Winter Haven Home ICF/DD-H)
• Gene Wayne Evans, D.D.S.

• Licensed Vocational Nurse in Fillmore, CA
• Providers in Fillmore, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.