Provider Demographics
NPI:1003383407
Name:SALCIDO, SARA JANE RENEE
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JANE RENEE
Last Name:SALCIDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CENTENNIAL LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7900
Mailing Address - Country:US
Mailing Address - Phone:541-393-0777
Mailing Address - Fax:458-205-7631
Practice Address - Street 1:1040 OAK ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3132
Practice Address - Country:US
Practice Address - Phone:541-342-6987
Practice Address - Fax:541-687-9279
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)