Healthcare Provider Details

I. General information

NPI: 1245661552
Provider Name (Legal Business Name): REBECCA SILVERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST RM C-5914
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

1975 4TH ST RM C-5914
SAN FRANCISCO CA
94143-2351
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1043
  • Fax: 415-502-4186
Mailing address:
  • Phone: 415-476-1043
  • Fax: 415-502-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95002523
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number209.010947
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: