Healthcare Provider Details

I. General information

NPI: 1770608317
Provider Name (Legal Business Name): LORI ANDREA SALINAS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 FERRY ST STE 7
MARTINEZ CA
94553-1145
US

IV. Provider business mailing address

84 BISHOP RD
CROCKETT CA
94525-1514
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-6544
  • Fax: 925-370-6504
Mailing address:
  • Phone: 510-612-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number45459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: