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NPI Code Detail

MEDICARE: JEANETTE SALAS NPA

MEDICARE: JEANETTE SALAS NPA
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
1363LF0000XFamily Nurse Practitioner464627CA
2363LW0102XWomen's Health Nurse Practitioner11310CA
3163W00000XRegistered Nurse464627CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1952662606OTHERCAGRP TAX ID #

General Provider Information

NPI Number : 1235242918
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE SALAS NPA
Provider Business Mailing Address
First Line : 2261 MARKET ST STE 10011
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94114-1612
Country : US
Telephone Number : 909-743-5915
Fax Number :
Provider Business Practice Location Address
First Line : 511 N HOLLYWOOD WAY
Second Line :
City : BURBANK
State : CA
Zip : 91505-3406
Country : US
Telephone Number : 818-841-0710
Fax Number : 818-347-4257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 11/27/2024

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