Healthcare Provider Details

I. General information

NPI: 1548490170
Provider Name (Legal Business Name): MR. VINCENT SALAVERIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SALVIO ST STE 28
CONCORD CA
94520-2495
US

IV. Provider business mailing address

4240 KEARNY MESA ROAD SUITE 120 PMB 1226
SAN DIEG0 CA
92111
US

V. Phone/Fax

Practice location:
  • Phone: 925-383-1096
  • Fax:
Mailing address:
  • Phone: 925-383-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: