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NPI 1689806895

NPI 1689806895 : STEPHANIE SILVINSON : TRACY, CA

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General NPI Number Information
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    NPI Number           |    1689806895
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHANIE SILVINSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/20/2009
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    Last Update Date     |    10/22/2018
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Provider Practice Location Address
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    Address Line         |    1660 W LINNE RD STE J-22 
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    City                 |    TRACY
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    State                |    CA
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    Zip                  |    95377-8024
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    Country              |    US
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    Telephone            |    209-832-7404
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1660 W LINNE RD STE J-22 
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    City                 |    TRACY
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    State                |    CA
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    Zip                  |    95377-8024
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    Country              |    US
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    Telephone            |    209-832-7404
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    98489
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    License Number State |    CA
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