Healthcare Provider Details

I. General information

NPI: 1669177929
Provider Name (Legal Business Name): HEATHER E SALAS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 LEEDS ST
DOWNEY CA
90242-3489
US

IV. Provider business mailing address

7735 LEEDS ST
DOWNEY CA
90242-3489
US

V. Phone/Fax

Practice location:
  • Phone: 562-719-2865
  • Fax:
Mailing address:
  • Phone: 562-719-2865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN725191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: