Provider Demographics
NPI:1700521739
Name:SALMERON, ELIZABETH JANET
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANET
Last Name:SALMERON
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 1:1003 N CHIPPEWA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3500
Mailing Address - Country:US
Mailing Address - Phone:323-799-7787
Mailing Address - Fax:
Practice Address - Street 1:1003 N CHIPPEWA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3500
Practice Address - Country:US
Practice Address - Phone:323-799-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician