Provider Demographics
NPI:1710100276
Name:SALCEDO, GUILLERMINA BARAJAS (RN)
Entity Type:Individual
Prefix:MRS
First Name:GUILLERMINA
Middle Name:BARAJAS
Last Name:SALCEDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:GUILLERMINA
Other - Middle Name:
Other - Last Name:TIRADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 8554
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95208-0554
Mailing Address - Country:US
Mailing Address - Phone:209-546-0849
Mailing Address - Fax:
Practice Address - Street 1:241 E 10TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4076
Practice Address - Country:US
Practice Address - Phone:209-831-5941
Practice Address - Fax:209-831-5964
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse