Provider Demographics
NPI:1376760066
Name:SILK, STEPHEN ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:SILK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 LA JOLLA VILLAGE DR
Mailing Address - Street 2:SUITE 550
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1402
Mailing Address - Country:US
Mailing Address - Phone:858-546-9888
Mailing Address - Fax:
Practice Address - Street 1:4180 LA JOLLA VILLAGE DR
Practice Address - Street 2:SUITE 550
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1402
Practice Address - Country:US
Practice Address - Phone:858-546-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist