Healthcare Provider Details

I. General information

NPI: 1164080883
Provider Name (Legal Business Name): CAITLIN MAYA SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date: 09/01/2021
Reactivation Date: 08/12/2026

III. Provider practice location address

12440 FIRESTONE BLVD STE 3015
NORWALK CA
90650-9333
US

IV. Provider business mailing address

12440 FIRESTONE BLVD STE 3015
NORWALK CA
90650-9333
US

V. Phone/Fax

Practice location:
  • Phone: 562-291-3477
  • Fax: 310-362-8948
Mailing address:
  • Phone: 562-291-3477
  • Fax: 310-362-8948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: