MEDICARE: DIANNA LYNN SALAZAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1104780048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA LYNN SALAZAR

Provider Business Mailing Address
First Line	:	11741 TELEGRAPH RD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3681
Country	:	US
Telephone Number	:	562-801-0318
Fax Number	:	562-949-3642

Provider Business Practice Location Address
First Line	:	11741 TELEGRAPH RD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3681
Country	:	US
Telephone Number	:	562-801-0318
Fax Number	:	562-949-3642

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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