Basic Information
| Provider Information | |||||||||
| NPI: | 1356495535 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALAS | ||||||||
| FirstName: | SHERRILYNN | ||||||||
| MiddleName: | LISA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 808 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953404600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093816860 | ||||||||
| FaxNumber: | 2093839666 | ||||||||
| Practice Location | |||||||||
| Address1: | 808 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953404600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093816860 | ||||||||
| FaxNumber: | 2093839666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | ASW 16240 | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.