Provider Demographics
NPI:1235961913
Name:SALINAS, LUIS ALEJANDRO
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ALEJANDRO
Last Name:SALINAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:ALEJANDRO
Other - Last Name:SALINAS-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4552 63RD ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-4200
Mailing Address - Country:US
Mailing Address - Phone:510-928-5504
Mailing Address - Fax:
Practice Address - Street 1:9355 E STOCKTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9476
Practice Address - Country:US
Practice Address - Phone:916-683-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst