Provider Demographics
NPI:1679960520
Name:SANTOS, LARINA M (MSW)
Entity type:Individual
Prefix:MISS
First Name:LARINA
Middle Name:M
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:LARINA
Other - Middle Name:M
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3245 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7809
Mailing Address - Country:US
Mailing Address - Phone:907-364-4445
Mailing Address - Fax:907-364-4487
Practice Address - Street 1:1046 SALMON CREEK LN
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-364-4445
Practice Address - Fax:907-364-4487
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical