Provider Demographics
NPI:1720597859
Name:SALMERON, SAMANTHA HELENA (CADC-CAS)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:HELENA
Last Name:SALMERON
Suffix:
Gender:F
Credentials:CADC-CAS
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:HELENA
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC-CAS
Mailing Address - Street 1:9718 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3635
Mailing Address - Country:US
Mailing Address - Phone:562-925-2777
Mailing Address - Fax:
Practice Address - Street 1:9718 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2688
Practice Address - Country:US
Practice Address - Phone:562-925-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC12071214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC12071214OtherCADC-CAS