Provider Demographics
NPI:1770035057
Name:SANTOYO, BIANCA
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:SANTOYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SUDCC
Mailing Address - Street 1:40700 CALIFORNIA OAKS RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5795
Mailing Address - Country:US
Mailing Address - Phone:951-894-5072
Mailing Address - Fax:951-894-7324
Practice Address - Street 1:40700 CALIFORNIA OAKS RD STE 202
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5789
Practice Address - Country:US
Practice Address - Phone:951-894-5072
Practice Address - Fax:951-894-7324
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA9066101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)