Provider Demographics
NPI:1801032974
Name:SALANT, JESSICA C (MFT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:C
Last Name:SALANT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E ST STE 512
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0353
Mailing Address - Country:US
Mailing Address - Phone:707-445-1285
Mailing Address - Fax:707-445-1626
Practice Address - Street 1:350 E ST
Practice Address - Street 2:SUITE 401
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0357
Practice Address - Country:US
Practice Address - Phone:707-445-1285
Practice Address - Fax:707-445-1626
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist