Provider Demographics
NPI:1700165016
Name:SALZ, DONALD LAWRENCE (EDD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LAWRENCE
Last Name:SALZ
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188506
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-8506
Mailing Address - Country:US
Mailing Address - Phone:916-813-2959
Mailing Address - Fax:915-443-1796
Practice Address - Street 1:2540 LAND PARK DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2244
Practice Address - Country:US
Practice Address - Phone:916-813-2959
Practice Address - Fax:916-443-1796
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14414103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist