Eduardo Gonzalez Santillan

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

641 Broadway St
King City, CA 93930-3231

Phone

(831) 525-8101

NPI assigned

Dec 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Sun Street Centers

  • Substance Abuse Rehabilitation Facility
  • King City, CA
  • NPI 1265923437
  NPD (past)

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1831737113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51201 PINE CANYON RD SPC 90",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939309729",
            "telephone_number": "831-258-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 BROADWAY ST",
            "city": "KING CITY",
            "state": "CA",
            "postal_code": "939303231",
            "telephone_number": "831-525-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLAN",
        "first_name": "EDUARDO",
        "middle_name": "GONZALEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "esantillan@sunstreet.org",
            "affiliation": "N",
            "address_1": "641 Broadway St",
            "city": "King City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "939303231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in King City, CA
• Providers in King City, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.