Provider Demographics
NPI:1922989458
Name:SANTOS LUCIANO, NAISHALIE
Entity type:Individual
Prefix:
First Name:NAISHALIE
Middle Name:
Last Name:SANTOS LUCIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE SARRIA 402
Mailing Address - Street 2:URB VALENCIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923
Mailing Address - Country:US
Mailing Address - Phone:787-214-9499
Mailing Address - Fax:
Practice Address - Street 1:1551 CALLE VICTORIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3123
Practice Address - Country:US
Practice Address - Phone:787-722-9595
Practice Address - Fax:787-722-9595
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6293103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling