Provider Demographics
NPI:1346365939
Name:SALAZAR, JOSE DANIEL
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:DANIEL
Last Name:SALAZAR
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 1:1729 VILLA AVE
Mailing Address - Street 2:APT B
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-4654
Mailing Address - Country:US
Mailing Address - Phone:805-636-6489
Mailing Address - Fax:805-856-0457
Practice Address - Street 1:26 W FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3104
Practice Address - Country:US
Practice Address - Phone:805-963-8961
Practice Address - Fax:805-963-8964
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1446101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1446OtherCOUNSELOR ADDICTION