Provider Demographics
NPI:1235323577
Name:VON SALTZA, CODY H
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:H
Last Name:VON SALTZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 FRISBEE RD
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:CA
Mailing Address - Zip Code:96064-9751
Mailing Address - Country:US
Mailing Address - Phone:530-340-0489
Mailing Address - Fax:
Practice Address - Street 1:1515 S OREGON ST
Practice Address - Street 2:SUITE A
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-3425
Practice Address - Country:US
Practice Address - Phone:530-842-3455
Practice Address - Fax:530-842-0632
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker