Provider Demographics
NPI:1508045014
Name:SANTILLI, ISABEL (MS)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:SANTILLI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 MYERS ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5525
Mailing Address - Country:US
Mailing Address - Phone:951-358-6874
Mailing Address - Fax:951-358-6176
Practice Address - Street 1:3075 MYERS ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5525
Practice Address - Country:US
Practice Address - Phone:951-358-6874
Practice Address - Fax:951-358-6176
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT95921106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist