Provider Demographics
NPI:1780137638
Name:SALDANA, SALVADOR JAAZIEL (ATC)
Entity type:Individual
Prefix:
First Name:SALVADOR
Middle Name:JAAZIEL
Last Name:SALDANA
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 33RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2412
Mailing Address - Country:US
Mailing Address - Phone:619-316-0959
Mailing Address - Fax:
Practice Address - Street 1:2798 HARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-3650
Practice Address - Country:US
Practice Address - Phone:619-385-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20000147332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer