Healthcare Provider Details

I. General information

NPI: 1073440525
Provider Name (Legal Business Name): PATRICK SALISBURY JR. AMFT, APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 CAPISTRANO AVE STE D
ATASCADERO CA
93422-7201
US

IV. Provider business mailing address

5855 CAPISTRANO AVE STE D
ATASCADERO CA
93422-7201
US

V. Phone/Fax

Practice location:
  • Phone: 805-952-3236
  • Fax:
Mailing address:
  • Phone: 805-952-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number160009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: