Basic Information
| Provider Information | |||||||||
| NPI: | 1629250600 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTISTEVAN | ||||||||
| FirstName: | FRANCINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1845 N FAIR OAKS AVE | ||||||||
| Address2: | SUITE 2600 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262968900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1845 N FAIR OAKS AVE | ||||||||
| Address2: | SUITE 2600 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262968900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2007 | ||||||||
| LastUpdateDate: | 05/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFTI59850 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.