1730206608 NPI number — MRS. BRIGIDA MARIA SALINAS MSW

Table of content: MRS. BRIGIDA MARIA SALINAS MSW (NPI 1730206608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730206608 NPI number — MRS. BRIGIDA MARIA SALINAS MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALINAS
Provider First Name:
BRIGIDA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAMUDIO
Provider Other First Name:
BRIGIDA
Provider Other Middle Name:
MARIA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730206608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2018
NPI Reactivation Date:
08/15/2018

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5901 GREEN VALLEY CIR STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULVER CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90230-6953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-258-4133
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1339 20TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90404-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-829-8552
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: ASW72194 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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