Provider Demographics
NPI:1811553605
Name:SANTANA, FRANCISCO MANUEL (HAD LICENSE)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:MANUEL
Last Name:SANTANA
Suffix:
Gender:M
Credentials:HAD LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 ORANGE ST # 4H
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3240
Mailing Address - Country:US
Mailing Address - Phone:909-793-2631
Mailing Address - Fax:
Practice Address - Street 1:454 ORANGE ST # 4H
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-3240
Practice Address - Country:US
Practice Address - Phone:909-793-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8506237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist