Healthcare Provider Details

I. General information

NPI: 1639865835
Provider Name (Legal Business Name): LILIANA SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAPITOL AVE BLDG B
FREMONT CA
94538-1514
US

IV. Provider business mailing address

26825 HUNTWOOD AVE APT 10
HAYWARD CA
94544-3335
US

V. Phone/Fax

Practice location:
  • Phone: 510-574-2032
  • Fax:
Mailing address:
  • Phone: 510-953-8865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: