Provider Demographics
NPI:1932969797
Name:SALDIVAR, ELSA YASMINE
Entity Type:Individual
Prefix:MRS
First Name:ELSA
Middle Name:YASMINE
Last Name:SALDIVAR
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 1:3908 CAROL DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-4878
Mailing Address - Country:US
Mailing Address - Phone:956-432-4617
Mailing Address - Fax:
Practice Address - Street 1:7210 W INTERSTATE 2 STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-9528
Practice Address - Country:US
Practice Address - Phone:956-897-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional