Provider Demographics
NPI:1700889466
Name:SALAIS, A JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:A
Middle Name:JOSEPH
Last Name:SALAIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 W OVERLAND RD #214
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1433
Mailing Address - Country:US
Mailing Address - Phone:925-942-7110
Mailing Address - Fax:208-297-6551
Practice Address - Street 1:10400 W OVERLAND RD #214
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1433
Practice Address - Country:US
Practice Address - Phone:925-942-7110
Practice Address - Fax:208-297-6551
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12750103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist