Healthcare Provider Details

I. General information

NPI: 1093647091
Provider Name (Legal Business Name): NELI MARIENE SALINAS LIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ROLAND WAY
OAKLAND CA
94621-2034
US

IV. Provider business mailing address

1416 85TH AVE APT 2
OAKLAND CA
94621-1750
US

V. Phone/Fax

Practice location:
  • Phone: 628-587-7297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: