Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 16078 | CA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 16078 | CA |
NPI | 1043392467 |
---|---|
Provider Name | Ms. Adriana Salas |
First Address | Lemon Grove, CA 91945-3810 |
Second Address | San Diego, CA 92161-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 23/04/2021 |