Provider Demographics
NPI:1083943047
Name:SANTAMARIA, RAYMOND JULIAN (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:JULIAN
Last Name:SANTAMARIA
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:MR
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:SANTAMARIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:8425 W 3RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4126
Mailing Address - Country:US
Mailing Address - Phone:888-573-1110
Mailing Address - Fax:323-375-1484
Practice Address - Street 1:8425 W 3RD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4126
Practice Address - Country:US
Practice Address - Phone:888-573-1110
Practice Address - Fax:323-375-1484
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43730101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health