Healthcare Provider Details

I. General information

NPI: 1134024490
Provider Name (Legal Business Name): DIANA SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10775 PIONEER TRL STE 214
TRUCKEE CA
96161-0234
US

IV. Provider business mailing address

10775 PIONEER TRL STE 214
TRUCKEE CA
96161-0234
US

V. Phone/Fax

Practice location:
  • Phone: 530-606-5491
  • Fax:
Mailing address:
  • Phone: 530-448-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRT1460561026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: