Provider Demographics
NPI:1124081567
Name:SALAZAR, DEBORAH MILLER (RN, PHN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MILLER
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-875-5000
Mailing Address - Fax:
Practice Address - Street 1:9333 TECH CENTER DR
Practice Address - Street 2:SUITE 800
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2583
Practice Address - Country:US
Practice Address - Phone:916-875-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 42586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse