Healthcare Provider Details

I. General information

NPI: 1093672453
Provider Name (Legal Business Name): SILVER SOUL CHRONICLES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CENTERPOINTE DR STE 700
LA PALMA CA
90623-2545
US

IV. Provider business mailing address

6 CENTERPOINTE DR STE 700
LA PALMA CA
90623-2545
US

V. Phone/Fax

Practice location:
  • Phone: 714-975-3025
  • Fax:
Mailing address:
  • Phone: 714-975-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JANICE RACHELLE JABONERO
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 714-975-3025