Most Relevant Information
Provider Data
| NPI Number: | 1003526765 |
| Provider Name: | GIANNY ALEXANDRA RUSSO SANTIAGO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/02/2022 |
| Last Updated: | 07/29/2024 |
Provider Practice Location
1855 W KATELLA AVE STE 150
ORANGE
CA
928673432
Practice Location Phone/Fax
| Phone: | 7143993480 |
| Fax: | 7143993481 |
Provider Mailing Location
1855 W KATELLA AVE STE 150
ORANGE
CA
928673432
Provider Mailing Phone/Fax
| Phone: | 7143993480 |
| Fax: | 7143993481 |