Provider Demographics
NPI:1760461826
Name:ABAD-SANTOS, CRISELDA C (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISELDA
Middle Name:C
Last Name:ABAD-SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21900 BURBANK BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7418
Mailing Address - Country:US
Mailing Address - Phone:818-992-3121
Mailing Address - Fax:888-959-5641
Practice Address - Street 1:21900 BURBANK BLVD
Practice Address - Street 2:STE 300
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7418
Practice Address - Country:US
Practice Address - Phone:818-992-3121
Practice Address - Fax:888-959-5641
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1051952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2162331OtherTRIWEST
CA0269000000041562OtherUNITED HEALTHCARE
CACS332AOtherMEDICARE PTAN
CA7971348OtherAETNA BEHAVIORAL HEALTH
CA0A105195OtherBLUE SHIELD OF CALIFORNIA
CA0A105195OtherBLUE SHIELD OF CALIFORNIA
CA0269000000041562OtherUNITED HEALTHCARE
CA0A105195OtherBLUE SHIELD OF CALIFORNIA