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Individual

ERICA C SANTAMARIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
233 WEST BASELINE ROAD, LA VERNE, CA 91750
(909) 593-2581
(909) 596-3567
Mailing address
P.O BOX 400, 233 WEST BASELINE ROAD, LA VERNE, CA 91750
(909) 593-2581
(909) 596-3567

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
225400000X
Rehabilitation Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7565A
OUTPATIENT MENTAL HEALTH
CA
Enumeration date
03/09/2007
Last updated
05/11/2017
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