Provider Demographics
NPI:1295082543
Name:SALINAS, ROGELIO JR (CATC-L)
Entity type:Individual
Prefix:MR
First Name:ROGELIO
Middle Name:
Last Name:SALINAS
Suffix:JR
Gender:M
Credentials:CATC-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 CARLMONT DR
Mailing Address - Street 2:#206
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-3453
Mailing Address - Country:US
Mailing Address - Phone:650-921-1859
Mailing Address - Fax:
Practice Address - Street 1:2151 CARLMONT DR
Practice Address - Street 2:#206
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3453
Practice Address - Country:US
Practice Address - Phone:650-921-1859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)