Healthcare Provider Details

I. General information

NPI: 1073427621
Provider Name (Legal Business Name): SAN JUANITA SILVA MENTAL HEALTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 SE 24TH AVE
HILLSBORO OR
97123-7209
US

IV. Provider business mailing address

1029 SE 24TH AVE
HILLSBORO OR
97123-7209
US

V. Phone/Fax

Practice location:
  • Phone: 986-206-0414
  • Fax:
Mailing address:
  • Phone: 986-206-0414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: