Healthcare Provider Details

I. General information

NPI: 1578497384
Provider Name (Legal Business Name): JUAN MANUEL SILVA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 W AVENUE K STE 105
LANCASTER CA
93534-6422
US

IV. Provider business mailing address

1817 W AVENUE K STE 105
LANCASTER CA
93534-6422
US

V. Phone/Fax

Practice location:
  • Phone: 213-965-2878
  • Fax:
Mailing address:
  • Phone: 213-965-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: