Provider Demographics
NPI:1770608317
Name:SALINAS, LORI ANDREA (MFT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANDREA
Last Name:SALINAS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 BISHOP RD
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:CA
Mailing Address - Zip Code:94525-1514
Mailing Address - Country:US
Mailing Address - Phone:510-612-9971
Mailing Address - Fax:
Practice Address - Street 1:411 FERRY ST STE 7
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1145
Practice Address - Country:US
Practice Address - Phone:925-370-6544
Practice Address - Fax:925-370-6504
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA261QM0801XOtherMENTAL HEALTH CENTER