Provider Demographics
NPI:1447791165
Name:SALGADO, JUAN M (LISAC #SA-0432 (ARIZ)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:M
Last Name:SALGADO
Suffix:
Gender:M
Credentials:LISAC #SA-0432 (ARIZ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 S. CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757
Mailing Address - Country:US
Mailing Address - Phone:520-879-6060
Mailing Address - Fax:
Practice Address - Street 1:7490 S. CAMINO DE OESTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85757
Practice Address - Country:US
Practice Address - Phone:520-879-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health