Provider Demographics
NPI:1992039887
Name:SANTIAGO, HUGHETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HUGHETTE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 HARBOR BLVD
Mailing Address - Street 2:BUILDING A
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-4017
Mailing Address - Country:US
Mailing Address - Phone:650-599-1037
Mailing Address - Fax:
Practice Address - Street 1:262 HARBOR BLVD
Practice Address - Street 2:BUILDING A
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4017
Practice Address - Country:US
Practice Address - Phone:650-599-1037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA753591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health