Healthcare Provider Details

I. General information

NPI: 1508347485
Provider Name (Legal Business Name): CASSANDRA LYNN SILVER PSYCHIATRIC NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N TUSTIN AVE STE 182
SANTA ANA CA
92705-3775
US

IV. Provider business mailing address

1100 W STEWART DR
ORANGE CA
92868-3891
US

V. Phone/Fax

Practice location:
  • Phone: 800-801-9833
  • Fax:
Mailing address:
  • Phone: 714-771-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95077126
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95012192
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: