Provider Demographics
NPI:1487715009
Name:SALASSI, ANNE T (LCSW)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:T
Last Name:SALASSI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BECK AVE
Mailing Address - Street 2:MAIL STATION 5-250
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6804
Mailing Address - Country:US
Mailing Address - Phone:707-784-8449
Mailing Address - Fax:
Practice Address - Street 1:275 BECK AVE
Practice Address - Street 2:MAIL STATION 5-230
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6804
Practice Address - Country:US
Practice Address - Phone:707-784-8449
Practice Address - Fax:707-432-3555
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 235661041C0700X
CA235661041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical