Provider Demographics
NPI:1477143816
Name:ALAS, SALVADOR I
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:I
Last Name:ALAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SALVADOR
Other - Middle Name:I
Other - Last Name:GARCIA-ALAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:469 BLYTHEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-5840
Mailing Address - Country:US
Mailing Address - Phone:707-280-6935
Mailing Address - Fax:
Practice Address - Street 1:2 PADRE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2114
Practice Address - Country:US
Practice Address - Phone:707-553-1784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician