Individual
ANGELO JOVITO CAEZAR SANTOS SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17782 COWAN, IRVINE, CA 92614-6030
(949) 722-7118
Mailing address
1003 CONCORD ST, COSTA MESA, CA 92626-2807
(714) 823-0069
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021619
CA
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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