Provider Demographics
NPI:1508927179
Name:TREVINO, SALVADOR DELGADO (PHD)
Entity Type:Individual
Prefix:MR
First Name:SALVADOR
Middle Name:DELGADO
Last Name:TREVINO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5276 HOLLISTER AVENUE
Mailing Address - Street 2:SUITE 356
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111
Mailing Address - Country:US
Mailing Address - Phone:805-698-0696
Mailing Address - Fax:805-683-4964
Practice Address - Street 1:5276 HOLLISTER AVENUE
Practice Address - Street 2:SUITE 356
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111
Practice Address - Country:US
Practice Address - Phone:805-698-0696
Practice Address - Fax:805-683-4964
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21937106H00000X
CALMFT21937106H00000X
CAPSY25108103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist