MEDICARE: CHERYL ELVERTA SILVA

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	224Z00000X	Occupational Therapy Assistant	OTA458	CA

General Provider Information

NPI Number	:	1861704033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL ELVERTA SILVA

Provider Business Mailing Address
First Line	:	359 COLUSA AVE
Second Line	:
City	:	KENSINGTON
State	:	CA
Zip	:	94707-1208
Country	:	US
Telephone Number	:	510-527-4740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 ALLSTON WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-1920
Country	:	US
Telephone Number	:	510-848-8774
Fax Number	:

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

Provider Enumeration Date	:	07/05/2010
Last Update Date	:	07/05/2010

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