MEDICARE: PRISCILLA THERESE SALVADOR

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	363L00000X	Nurse Practitioner	95020997	CA

General Provider Information

NPI Number	:	1982342812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA THERESE SALVADOR

Provider Business Mailing Address
First Line	:	455 N GARFIELD AVE
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1201
Country	:	US
Telephone Number	:	833-476-7377
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 W FOOTHILL BLVD
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-3364
Country	:	US
Telephone Number	:	626-963-2816
Fax Number	:

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

Provider Enumeration Date	:	05/20/2022
Last Update Date	:	12/05/2025

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