Healthcare Provider Details

I. General information

NPI: 1679334221
Provider Name (Legal Business Name): CONI M SALGADO ZINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 CENTRAL AVE STE 400
RIVERSIDE CA
92506-5907
US

IV. Provider business mailing address

53080 CESAR CHAVEZ ST SPC B14
COACHELLA CA
92236-6001
US

V. Phone/Fax

Practice location:
  • Phone: 951-533-5263
  • Fax: 951-462-5220
Mailing address:
  • Phone: 760-625-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: