Healthcare Provider Details

I. General information

NPI: 1699096412
Provider Name (Legal Business Name): MARTHA I SALAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 CONSTITUTION BLVD BLDG 200, FLOOR 1, SUITE 101
SALINAS CA
93906
US

IV. Provider business mailing address

1615 BUNKER HILL WAY SUITE 100
SALINAS CA
93906-6013
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4124
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: