Provider Demographics
NPI:1376357723
Name:SANTOS, ERNEST GLENN HILLS
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:GLENN HILLS
Last Name:SANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 AZORES CT
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-3027
Mailing Address - Country:US
Mailing Address - Phone:925-595-1077
Mailing Address - Fax:
Practice Address - Street 1:207 AZORES CT
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-3027
Practice Address - Country:US
Practice Address - Phone:925-595-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN732907164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse