Provider Demographics
NPI:1659079176
Name:SANTIAGO, ROBERTO FRANCISCO (ACSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:FRANCISCO
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1811
Mailing Address - Country:US
Mailing Address - Phone:646-675-4752
Mailing Address - Fax:
Practice Address - Street 1:1361 19TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1811
Practice Address - Country:US
Practice Address - Phone:646-675-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1130671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical