MEDICARE: MR. PAUL ANTHONY SLAVIERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265612360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL ANTHONY SLAVIERO

Provider Business Mailing Address
First Line	:	4450 JONQUIL DR
Second Line	:	4450 JONQUIL DR
City	:	SAN JOSE
State	:	CA
Zip	:	95136-2059
Country	:	US
Telephone Number	:	408-445-0797
Fax Number	:

Provider Business Practice Location Address
First Line	:	4450 JONQUIL DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95136-2059
Country	:	US
Telephone Number	:	408-445-0797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	11/06/2007

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