Provider Demographics
NPI:1043872070
Name:HERNANDEZ SANTIAGO, NAYELI LIZBETH (ACSW)
Entity Type:Individual
Prefix:
First Name:NAYELI
Middle Name:LIZBETH
Last Name:HERNANDEZ SANTIAGO
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 ARTESIA BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2542
Mailing Address - Country:US
Mailing Address - Phone:562-860-8838
Mailing Address - Fax:562-860-0248
Practice Address - Street 1:11050 ARTESIA BLVD STE E
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2542
Practice Address - Country:US
Practice Address - Phone:562-860-8838
Practice Address - Fax:562-860-0248
Is Sole Proprietor?:No
Enumeration Date:2019-06-29
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAACSW104815101YM0800X, 104100000X, 1041C0700X
171M00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program