Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1395870620 | CA |
NPI | 1003433327 |
---|---|
Provider Name | Oscar Salinas |
First Address | Los Angeles, CA 90011-1237 |
Second Address | Los Angeles, CA 90011-1237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2020 |
Last Update Date | 02/07/2020 |