Basic Information
| Provider Information | |||||||||
| NPI: | 1528678091 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTOS | ||||||||
| FirstName: | MAGALY | ||||||||
| MiddleName: | ARLEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 140 CROSSOVER | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926181303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517276396 | ||||||||
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| Practice Location | |||||||||
| Address1: | 525 CABRILLO PARK DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927015017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149534455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2020 | ||||||||
| LastUpdateDate: | 12/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 105357 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.