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NPI 1609798115

NPI 1609798115 : SALMA HEALTH LLC : SAN MATEO, CA

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General NPI Number Information
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    NPI Number           |    1609798115
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    Entity Type          |    Organization 
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    Legal Business Name  |    SALMA HEALTH LLC 
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Dates
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    Enumeration Date     |    07/27/2026
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    Last Update Date     |    07/27/2026
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Provider Practice Location Address
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    Address Line         |    400 CONCAR DR STE 4-157 
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    City                 |    SAN MATEO
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    State                |    CA
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    Zip                  |    94402-2681
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    Country              |    US
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    Telephone            |    858-277-2659
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    400 CONCAR DR STE 4-157 
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    City                 |    SAN MATEO
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    State                |    CA
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    Zip                  |    94402-2681
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    Country              |    US
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    Telephone            |    858-277-2659
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. BRANDON  BENTZLEY 
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    Credential           |    MD
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    Telephone            |    856-449-7057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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