Provider Demographics
NPI:1306525662
Name:SANTIAGO, TOBIAH M (FNP-C)
Entity type:Individual
Prefix:
First Name:TOBIAH
Middle Name:M
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 WARING RD STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4499
Mailing Address - Country:US
Mailing Address - Phone:760-724-8782
Mailing Address - Fax:760-842-7801
Practice Address - Street 1:3923 WARING RD STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4499
Practice Address - Country:US
Practice Address - Phone:760-724-8782
Practice Address - Fax:760-842-7801
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily