Basic Information
Provider Information
NPI: 1316026859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANTOYO
FirstName: DULCE
MiddleName: MARIA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3751 STOCKER ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900085101
CountryCode: US
TelephoneNumber: 3232983680
FaxNumber: 3232964079
Practice Location
Address1: 3751 STOCKER ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900085101
CountryCode: US
TelephoneNumber: 3232983680
FaxNumber: 3232964079
Other Information
ProviderEnumerationDate: 11/03/2006
LastUpdateDate: 02/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X92573CAY Behavioral Health & Social Service ProvidersSocial Worker 
101YM0800X36943CAN Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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