Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | CA |
NPI | 1003227463 |
---|---|
Provider Name | Cesar Maximilian Salazar |
First Address | Brea, CA 92821-4038 |
Second Address | Los Gatos, CA 95030-6227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2014 |
Last Update Date | 19/05/2014 |