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NPI Code Detail

MEDICARE: DESTENY SALAS

MEDICARE: DESTENY SALAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1558109512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTENY SALAS
Provider Business Mailing Address
First Line : 437 N WHITE RD APT 8
Second Line :
City : SAN JOSE
State : CA
Zip : 95127-1442
Country : US
Telephone Number : 408-420-6757
Fax Number :
Provider Business Practice Location Address
First Line : 577 SALMAR AVE
Second Line :
City : CAMPBELL
State : CA
Zip : 95008-1453
Country : US
Telephone Number : 669-242-5090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2024
Last Update Date : 07/16/2024

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Directions to “ DESTENY SALAS ” Practice Location

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