Provider Demographics
NPI:1033354618
Name:SANTIAGO-COLE, GAIL LYNN
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:LYNN
Last Name:SANTIAGO-COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E CARSON ST STE A
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2866
Mailing Address - Country:US
Mailing Address - Phone:530-458-0520
Mailing Address - Fax:530-458-7751
Practice Address - Street 1:162 E CARSON ST STE A
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2866
Practice Address - Country:US
Practice Address - Phone:530-458-0520
Practice Address - Fax:530-458-7751
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator