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General NPI Number Information
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NPI Number | 1174092902
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Entity Type | Individual
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Provider Name | MARY JANE NERONA SALO MSN,FNP,PHD
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Gender | Female
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Dates
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Enumeration Date | 11/22/2018
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 100 W AMERICAN CANYON RD STE K6
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-4195
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Country | US
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Telephone | 707-567-7940
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Fax |
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Provider Business Mailing Address
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Address Line | 9010 CAMBRIDGE CIR
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City | VALLEJO
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State | CA
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Zip | 94591-8593
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Country | US
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Telephone | 707-567-7940
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95009182
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License Number State | CA
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