Provider Demographics
NPI:1346800208
Name:SALGADO, ANTONIO JR
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:SALGADO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11541 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3898
Mailing Address - Country:US
Mailing Address - Phone:562-923-9414
Mailing Address - Fax:
Practice Address - Street 1:11541 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3898
Practice Address - Country:US
Practice Address - Phone:562-923-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW103453101YM0800X
CAASW67374101YM0800X
225400000X
CAACSW103453104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical