Provider Demographics
NPI:1114080496
Name:SALSBURY, LYNN BRESSANUTTI (PHD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:BRESSANUTTI
Last Name:SALSBURY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 E BIDWELL ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3406
Mailing Address - Country:US
Mailing Address - Phone:916-983-1904
Mailing Address - Fax:916-983-1981
Practice Address - Street 1:2360 E BIDWELL ST
Practice Address - Street 2:SUITE 107
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3406
Practice Address - Country:US
Practice Address - Phone:916-983-1904
Practice Address - Fax:916-983-1981
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical