Healthcare Provider Details

I. General information

NPI: 1003258468
Provider Name (Legal Business Name): BRENDA SALCEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 DIVISADERO ST # 5
SAN FRANCISCO CA
94115-3012
US

IV. Provider business mailing address

554 CLAYTON ST UNIT 170351
SAN FRANCISCO CA
94117-6204
US

V. Phone/Fax

Practice location:
  • Phone: 408-256-0523
  • Fax:
Mailing address:
  • Phone: 408-256-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: