Healthcare Provider Details

I. General information

NPI: 1962316513
Provider Name (Legal Business Name): CHRISTEL DAWN SALAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7231 BOULDER AVE PMB 608
HIGHLAND CA
92346
US

IV. Provider business mailing address

7231 BOULDER AVE PMB 608
HIGHLAND CA
92346
US

V. Phone/Fax

Practice location:
  • Phone: 909-654-5702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number122823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: