Individual provider Active NPI

Renee Michelle Santos, LMHC, LPCC

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1811143753
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7901 Issued in CA
Practice address
4660 Viewridge Ave
San Diego, CA 92123-1638
Phone
(619) 277-9188
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10467 MA
Mental Health Counselor 101YM0800X 7901 CA Primary

Addresses

Primary practice location

4660 Viewridge Ave
San Diego, CA 92123-1638

Mailing address

2561 Raymell Dr
San Diego, CA 92123-3543
Phone (508) 745-9362

Other practice location 1

2561 Raymell Dr
San Diego, CA 92123-3543
Phone (508) 745-9362

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
10467MAMDMental Health Counselor
7901CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayside Youth and Family Support Network Mental Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1811143753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 RAYMELL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233543",
            "telephone_number": "508-745-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 VIEWRIDGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231638",
            "telephone_number": "619-277-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2561 Raymell Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921233543",
            "country_code": "US",
            "telephone_number": "508-745-9362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "RENEE",
        "middle_name": "MICHELLE",
        "credential": "LMHC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2023-02-14",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10467",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "7901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.