Provider Demographics
NPI:1851832679
Name:SALMON, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SALMON
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 1:2800 JEFFERSON ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2800 JEFFERSON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4966
Practice Address - Country:US
Practice Address - Phone:707-637-4970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 11411235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11411OtherSPEECH LANGUAGE PATHOLOGY RPE TEMPORARY LICENSE