Individual provider Active NPI

Kristopher L Bland Salas, AMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1558953802
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT122373 Issued in CA
Practice address
6276 N 1St St Ste 103
Fresno, CA 93710-5400
Phone
(559) 712-4300
NPI assigned
Feb 8, 2021
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT122373 CA Primary

Addresses

Primary practice location

6276 N 1St St Ste 103
Fresno, CA 93710-5400

Mailing address

6276 N 1St St Ste 103
Fresno, CA 93710-5400
Phone (559) 712-4300

Other identifiers 1

IdentifierTypeStateIssuer
AMFT122373OtherCAAMFT122373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT122373CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1558953802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6276 N 1ST ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105400",
            "telephone_number": "559-712-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 N 1ST ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105400",
            "telephone_number": "559-712-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND SALAS",
        "first_name": "KRISTOPHER",
        "middle_name": "L",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT122373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMFT122373",
            "identifier": "AMFT122373",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.