Individual provider Active NPI

Andres Gonzalez-Santiago

  • Student in an Organized Health Care Education/Training Program
  • Arlington, VA
National Provider Identifier
1578301313
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2120 Washington Blvd FL 4
Arlington, VA 22204-5718
Phone
(703) 228-5191
NPI assigned
Jul 16, 2024
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2120 Washington Blvd FL 4
Arlington, VA 22204-5718

Mailing address

2989 Oakleigh LN
Oakton, VA 22124-2538
Phone (703) 457-0460

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

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1578301313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2989 OAKLEIGH LN",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221242538",
            "telephone_number": "703-457-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 WASHINGTON BLVD FL 4",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045718",
            "telephone_number": "703-228-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-SANTIAGO",
        "first_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.