Provider Demographics
NPI:1801033097
Name:SALONEN, KENNETH J
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:J
Last Name:SALONEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 BISSO LN
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4897
Mailing Address - Country:US
Mailing Address - Phone:925-521-5620
Mailing Address - Fax:
Practice Address - Street 1:2425 BISSO LN
Practice Address - Street 2:SUITE #100
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4897
Practice Address - Country:US
Practice Address - Phone:925-521-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS12062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health