Provider Demographics
NPI:1043425077
Name:SILVER, JUNELL SAYLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUNELL
Middle Name:SAYLES
Last Name:SILVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95001-1523
Mailing Address - Country:US
Mailing Address - Phone:831-688-1645
Mailing Address - Fax:831-603-3424
Practice Address - Street 1:412 CEDAR ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4369
Practice Address - Country:US
Practice Address - Phone:831-688-1645
Practice Address - Fax:831-603-3424
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19401103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical