MEDICARE: FALAYA DESILVA

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	174400000X	Specialist
2	106H00000X	Marriage & Family Therapist	69941	CA

General Provider Information

NPI Number	:	1669675781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALAYA DESILVA

Provider Business Mailing Address
First Line	:	2275 S MAIN ST
Second Line	:	201
City	:	CORONA
State	:	CA
Zip	:	92882-5303
Country	:	US
Telephone Number	:	951-279-1333
Fax Number	:	951-279-8333

Provider Business Practice Location Address
First Line	:	2275 S MAIN ST
Second Line	:	201
City	:	CORONA
State	:	CA
Zip	:	92882-5303
Country	:	US
Telephone Number	:	951-279-1333
Fax Number	:	951-279-8333

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

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	06/27/2014

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Directions to “ FALAYA DESILVA ” Practice Location

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