Provider Demographics
NPI:1467183665
Name:SCHUTZ-RAMON, ISAAC SANTIAGO
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:SANTIAGO
Last Name:SCHUTZ-RAMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 WALLER AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-7240
Mailing Address - Country:US
Mailing Address - Phone:510-828-6325
Mailing Address - Fax:
Practice Address - Street 1:DEPT LA 22763
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91185-5435
Practice Address - Country:US
Practice Address - Phone:866-523-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician