Healthcare Provider Details

I. General information

NPI: 1851893085
Provider Name (Legal Business Name): SAUL SALMERON MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 AZUSA CT STE 110
RANCHO CUCAMONGA CA
91730-4933
US

IV. Provider business mailing address

11175 AZUSA CT STE 110
RANCHO CUCAMONGA CA
91730-4933
US

V. Phone/Fax

Practice location:
  • Phone: 909-962-1485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT129462
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number104795
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: