Provider Demographics
NPI:1033695432
Name:SANTOS, VANESSA DOMINGA
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:DOMINGA
Last Name:SANTOS
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 1:6355 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:818-650-1901
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:6355 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-650-1901
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)