Provider Demographics
NPI:1437606118
Name:SANTIAGO, VANESSA (DPT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:ARREDONDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1316 PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-5468
Mailing Address - Country:US
Mailing Address - Phone:858-382-9461
Mailing Address - Fax:
Practice Address - Street 1:4901 S MONACO ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3428
Practice Address - Country:US
Practice Address - Phone:303-796-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist