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General NPI Number Information
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NPI Number | 1164226429
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Entity Type | Individual
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Provider Name | KEUMBI GEONNA SALCEDO MA,
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 850 MERCHANT ST
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City | VACAVILLE
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State | CA
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Zip | 95688-6900
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Country | US
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Telephone | 707-446-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1168 BEELARD DR
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City | VACAVILLE
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State | CA
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Zip | 95687-5544
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Country | US
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Telephone | 707-689-4972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | AMFT152862
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License Number State | CA
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