Provider Demographics
NPI:1780098947
Name:DELOS SANTOS, VAN
Entity type:Individual
Prefix:
First Name:VAN
Middle Name:
Last Name:DELOS 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 1:270 HOOKAHI ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1466
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:270 HOOKAHI ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1466
Practice Address - Country:US
Practice Address - Phone:808-242-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor