Provider Demographics
NPI:1700889466
Name:SALAIS, A. JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:A.
Middle Name:JOSEPH
Last Name:SALAIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CITRUS CIR
Mailing Address - Street 2:STE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2665
Mailing Address - Country:US
Mailing Address - Phone:925-942-7110
Mailing Address - Fax:925-945-7001
Practice Address - Street 1:3000 CITRUS CIR
Practice Address - Street 2:STE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2665
Practice Address - Country:US
Practice Address - Phone:925-942-7110
Practice Address - Fax:925-945-7001
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12750103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist