Provider Demographics
NPI:1457956773
Name:ALCANTARA, APRIL THERESE DELOS SANTOS
Entity Type:Individual
Prefix:
First Name:APRIL THERESE
Middle Name:DELOS SANTOS
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 MARTIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-8610
Mailing Address - Country:US
Mailing Address - Phone:707-399-4520
Mailing Address - Fax:707-399-4521
Practice Address - Street 1:2420 MARTIN RD STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-8610
Practice Address - Country:US
Practice Address - Phone:707-399-4520
Practice Address - Fax:707-399-4521
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator