Marisa Rose Santiago, PT, DPT
Physical Therapist, Pediatrics in Fullerton, CA. Individual provider (NPI-1).
NPI number1104768977
StatusActive
Last updated in NPPESApr 8, 2026
Details
- NPI
- 1104768977
- Entity type
- Individual (NPI-1)
- Name
- Marisa Rose Santiago
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 8, 2026
- Certification date
- Apr 8, 2026
- Last updated
- Apr 8, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251P0200X | Physical Therapist, Pediatrics | 302434 | CA | Yes |
Practice location
233 Orangefair MallFullerton, CA 92832-3038
Phone 714-870-6116
Mailing address
14520 Close StWhittier, CA 90604-1812
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Pediatric Physical Therapist providers in Fullerton, CA
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All 24 Pediatric Physical Therapist providers in Fullerton · All 6,385 providers in Fullerton
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