Provider Demographics
NPI:1003027004
Name:SALIN, ELIZABETH CRONK (MFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CRONK
Last Name:SALIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3230
Mailing Address - Country:US
Mailing Address - Phone:415-457-2206
Mailing Address - Fax:707-778-8441
Practice Address - Street 1:1214 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3230
Practice Address - Country:US
Practice Address - Phone:415-457-2206
Practice Address - Fax:707-778-8441
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist