Provider Demographics
NPI:1619039005
Name:PARIS-SALB, RANDI (PSYD, RN)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:
Last Name:PARIS-SALB
Suffix:
Gender:F
Credentials:PSYD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3027
Mailing Address - Country:US
Mailing Address - Phone:916-973-5300
Mailing Address - Fax:
Practice Address - Street 1:1643 EUREKA RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3027
Practice Address - Country:US
Practice Address - Phone:916-973-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16435103T00000X
CA302448 - 3652363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner