Healthcare Provider Details

I. General information

NPI: 1699063529
Provider Name (Legal Business Name): MS. JAMIE SALAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

IV. Provider business mailing address

2919 MISSION ST
SAN FRANCISCO CA
94110-3917
US

V. Phone/Fax

Practice location:
  • Phone: 415-229-0500
  • Fax:
Mailing address:
  • Phone: 415-229-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: