Provider Demographics
NPI:1124188495
Name:SILVA, RAMONA (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:
Last Name:SILVA
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 1:2100 SAN VENITO RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2578
Mailing Address - Country:US
Mailing Address - Phone:505-401-9786
Mailing Address - Fax:505-243-5255
Practice Address - Street 1:1301 LOMAS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1201
Practice Address - Country:US
Practice Address - Phone:505-401-9786
Practice Address - Fax:505-401-9786
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM711103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM92782850Medicaid
NM10013069Medicare UPIN
NM201042100Medicare UPIN