Provider Demographics
NPI:1225551526
Name:SALINAS, ROSA AURELIA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:AURELIA
Last Name:SALINAS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BROOKSIDE AVE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-2505
Mailing Address - Country:US
Mailing Address - Phone:909-904-7513
Mailing Address - Fax:
Practice Address - Street 1:20 NEVADA ST STE 202
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4225
Practice Address - Country:US
Practice Address - Phone:909-904-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112770106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE TO REPORT