1295960102 NPI number — JIME SALCEDO PSY.D.

Table of content: JIME SALCEDO PSY.D. (NPI 1295960102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295960102 NPI number — JIME SALCEDO PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALCEDO
Provider First Name:
JIME
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALCIDO
Provider Other First Name:
JIM
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1295960102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF CALIFORNIA SANTA BARBARA
Provider Second Line Business Mailing Address:
COUNSELING AND PSYCHOLOGICAL SERVICES BLDG 559
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93106-7030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-676-1264
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 GENG RD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94303-3307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-646-3243
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2009

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: 103TC0700X , with the licence number:  PSY24524 , 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)





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