Provider Demographics
NPI:1679203533
Name:SALAS, JULIANA MICHELLE
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:MICHELLE
Last Name:SALAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 DEODAR AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-4627
Mailing Address - Country:US
Mailing Address - Phone:661-645-6797
Mailing Address - Fax:
Practice Address - Street 1:3601 CALLE TECATE
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5056
Practice Address - Country:US
Practice Address - Phone:661-645-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA390200000XOtherVENTURA COUNTY BEHAVIORAL HEALTH