Provider Demographics
NPI:1477706752
Name:SALINAS, R. BRIAN (PSYD, PPS)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:BRIAN
Last Name:SALINAS
Suffix:
Gender:M
Credentials:PSYD, PPS
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:SALINAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, PPS
Mailing Address - Street 1:5669 SNELL AVE # 355
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3328
Mailing Address - Country:US
Mailing Address - Phone:408-607-3743
Mailing Address - Fax:
Practice Address - Street 1:279 CHARLES ST
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086
Practice Address - Country:US
Practice Address - Phone:408-607-3743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29400103TC0700X
CA#36004103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA103T00000XMedicaid
CA103T00000XMedicare Oscar/Certification
CA103T00000XMedicare PIN
CA103T00000XMedicaid