Provider Demographics
NPI:1184013021
Name:CAZARES, SILVANO
Entity Type:Individual
Prefix:
First Name:SILVANO
Middle Name:
Last Name:CAZARES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 S MELROSE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4039
Mailing Address - Country:US
Mailing Address - Phone:559-827-5838
Mailing Address - Fax:
Practice Address - Street 1:3188 AIRWAY AVE
Practice Address - Street 2:UNIT
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4652
Practice Address - Country:US
Practice Address - Phone:714-689-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health