Healthcare Provider Details

I. General information

NPI: 1700549128
Provider Name (Legal Business Name): LUIS SALGADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 PLUMAS ST
YUBA CITY CA
95991-4437
US

IV. Provider business mailing address

162 E CARSON ST
COLUSA CA
95932-2880
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7478
  • Fax:
Mailing address:
  • Phone: 530-434-2405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
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 Number127187
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: