Provider Demographics
NPI:1154318590
Name:SILVA, DONNA (NP)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8418
Mailing Address - Country:US
Mailing Address - Phone:209-544-7300
Mailing Address - Fax:209-544-7323
Practice Address - Street 1:4120 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8418
Practice Address - Country:US
Practice Address - Phone:209-544-7300
Practice Address - Fax:209-544-7323
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN238245208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMS0525014OtherDEA