Individual
NATHAN ALLEN SANTIBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
27281 LAS RAMBLAS STE 255, MISSION VIEJO, CA 92691-6324
(714) 421-2757
Mailing address
PO BOX 738, SAN JUAN CAPISTRANO, CA 92693-0738
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021131
CA
Other
Enumeration date
08/09/2022
Last updated
08/11/2022
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