Healthcare Provider Details

I. General information

NPI: 1033946363
Provider Name (Legal Business Name): DESERRY SALGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47470 VAN BUREN ST
INDIO CA
92201-7139
US

IV. Provider business mailing address

82934 CIVIC CENTER DR
INDIO CA
92201-4308
US

V. Phone/Fax

Practice location:
  • Phone: 760-477-0733
  • Fax:
Mailing address:
  • Phone: 760-477-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: