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NPI 1306661905

NPI 1306661905 : AMY SALAZAR : PERRIS, CA

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General NPI Number Information
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    NPI Number           |    1306661905
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    Entity Type          |    Individual 
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    Provider Name        |    AMY SALAZAR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/19/2024
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    Last Update Date     |    05/15/2025
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Provider Practice Location Address
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    Address Line         |    2560 N PERRIS BLVD STE N1 
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    City                 |    PERRIS
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    State                |    CA
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    Zip                  |    92571-3251
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    Country              |    US
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    Telephone            |    951-940-6755
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2550 N HOLLYWOOD WAY STE 301 
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    City                 |    BURBANK
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    State                |    CA
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    Zip                  |    91505-5025
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    Country              |    US
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    Telephone            |    866-727-8274
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    175T00000X
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    Taxonomy Name        |    Peer Specialist
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    License Number       |    MPSS-FCUGKZ
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    License Number State |    CA
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