Provider Demographics
NPI:1548474729
Name:SALAT, JOAN (LCSW)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:SALAT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2714
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-2601
Mailing Address - Country:US
Mailing Address - Phone:858-353-2070
Mailing Address - Fax:858-523-1037
Practice Address - Street 1:16935 W BERNARDO DR
Practice Address - Street 2:SUITE 237
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1634
Practice Address - Country:US
Practice Address - Phone:858-353-2070
Practice Address - Fax:858-523-1037
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALS105461041C0700X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist