Healthcare Provider Details

I. General information

NPI: 1790624054
Provider Name (Legal Business Name): NILZA MERLIM MERLIM PERENTEL SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NILZA BACKES MT-BC

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W BULLARD AVE APT 178
CLOVIS CA
93612-0981
US

IV. Provider business mailing address

55 W BULLARD AVE APT 178
CLOVIS CA
93612-0981
US

V. Phone/Fax

Practice location:
  • Phone: 407-810-4260
  • Fax:
Mailing address:
  • Phone: 407-810-4260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number20148
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: