Provider Demographics
NPI:1760958516
Name:NOBLE-SANTIAGO, JOSHUA (MSW)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:NOBLE-SANTIAGO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ITURREGUI PLAZA SHOPPING CENTER SUITE 17
Mailing Address - Street 2:AVENIDA 65 INFANTERIA 1135
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-769-7100
Mailing Address - Fax:787-758-8936
Practice Address - Street 1:ITURREGUI PLAZA SHOPPING CENTER SUITE 17
Practice Address - Street 2:AVENIDA 65 INFANTERIA 1135
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-769-7100
Practice Address - Fax:787-758-8936
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR132591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13259OtherSOCIAL WORKER