Miriam Salamanca
Individual provider Active NPI Licensed Psychiatric Technician · Nipomo, CA
NPI 1275913576 · NPPES record last updated Jun 2, 2015
Key facts
- NPI
- 1275913576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Psychiatric Technician 167G00000X
- License
- 31479 (CA)
- Practice address
- 130 E Branch St
Nipomo, CA 93444-5005 - Phone
- (805) 720-4483
- NPI assigned
- Jun 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31479 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 31479 | CA | Yes |
Addresses
Primary practice location
130 E Branch St
Nipomo, CA 93444-5005
Mailing address
PO Box 1626
San Luis Obispo, CA 93406-1626
Phone (805) 720-4483
Other providers in Nipomo, CA
- Valerie Jenine Reilly
- Emily Renk Hawthorne
- Katherine Retzer
- David J Richard
- Jillianne Russi Ruppert
- Jennifer Mary Sale
- Sayyed Khalis Salim
- Kerri Marie Schofield
- Natalia V Schwartz
- Frank Eugene Scott Jr.
All providers in Nipomo, CA · Licensed Psychiatric Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.