Provider Demographics
NPI:1518341833
Name:PAGE, THEMA SALAZAR (MSW)
Entity Type:Individual
Prefix:MS
First Name:THEMA
Middle Name:SALAZAR
Last Name:PAGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2753
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-7753
Mailing Address - Country:US
Mailing Address - Phone:510-404-8940
Mailing Address - Fax:
Practice Address - Street 1:24100 AMADOR ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544
Practice Address - Country:US
Practice Address - Phone:510-780-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical