Healthcare Provider Details

I. General information

NPI: 1821632084
Provider Name (Legal Business Name): YARELI SALINAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4618 FOUNTAIN AVE
LOS ANGELES CA
90029-1830
US

IV. Provider business mailing address

4618 FOUNTAIN AVE
LOS ANGELES CA
90029-1830
US

V. Phone/Fax

Practice location:
  • Phone: 323-953-7170
  • Fax:
Mailing address:
  • Phone: 323-953-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: