1407441397 NPI number — MARIA ROSARIO SALAZAR URENO AMFT

Table of content: MARIA ROSARIO SALAZAR URENO AMFT (NPI 1407441397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407441397 NPI number — MARIA ROSARIO SALAZAR URENO AMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALAZAR URENO
Provider First Name:
MARIA
Provider Middle Name:
ROSARIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SALAZAR
Provider Other First Name:
MARIA
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:
1407441397
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2010 N FINE AVE STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93727-1558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-457-6976
Provider Business Mailing Address Fax Number:
559-256-5733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2010 N FINE AVE STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93727-1558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-457-6976
Provider Business Practice Location Address Fax Number:
559-256-5733
Provider Enumeration Date:
03/03/2021

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: 106H00000X , with the licence number:  AMFT123662 , 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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