Provider Demographics
NPI:1730206608
Name:SALINAS, BRIGIDA MARIA (MSW)
Entity type:Individual
Prefix:MRS
First Name:BRIGIDA
Middle Name:MARIA
Last Name:SALINAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:BRIGIDA
Other - Middle Name:MARIA
Other - Last Name:ZAMUDIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5901 GREEN VALLEY CIR STE 320
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6953
Mailing Address - Country:US
Mailing Address - Phone:310-258-4133
Mailing Address - Fax:
Practice Address - Street 1:1339 20TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2033
Practice Address - Country:US
Practice Address - Phone:310-829-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2018-08-15
Deactivation Date:2018-07-17
Deactivation Code:
Reactivation Date:2018-08-15
Provider Licenses
StateLicense IDTaxonomies
225400000X
CAASW72194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10Medicaid