Provider Demographics
NPI:1063653434
Name:SALAH, JANELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:
Last Name:SALAH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 TELEGRAPH AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1965
Mailing Address - Country:US
Mailing Address - Phone:510-540-5970
Mailing Address - Fax:
Practice Address - Street 1:3120 TELEGRAPH AVE STE 11
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1965
Practice Address - Country:US
Practice Address - Phone:510-540-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36056106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist