Healthcare Provider Details

I. General information

NPI: 1639474752
Provider Name (Legal Business Name): EDNA LILIAN SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 N EUCLID AVE
UPLAND CA
91786-6031
US

IV. Provider business mailing address

4666 CASS ST
SAN DIEGO CA
92109-2860
US

V. Phone/Fax

Practice location:
  • Phone: 909-985-1864
  • Fax:
Mailing address:
  • Phone: 323-484-2402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: