Provider Demographics
NPI:1265014559
Name:SALGADO, ALISANDRA
Entity type:Individual
Prefix:
First Name:ALISANDRA
Middle Name:
Last Name:SALGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-4718
Mailing Address - Country:US
Mailing Address - Phone:209-205-1058
Mailing Address - Fax:209-205-1062
Practice Address - Street 1:642 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4718
Practice Address - Country:US
Practice Address - Phone:209-205-1058
Practice Address - Fax:209-205-1062
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT92202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health