Provider Demographics
NPI:1407231947
Name:SILVA, ELIJIO
Entity Type:Individual
Prefix:
First Name:ELIJIO
Middle Name:
Last Name:SILVA
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 1:6711 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504
Mailing Address - Country:US
Mailing Address - Phone:951-352-3943
Mailing Address - Fax:951-637-1577
Practice Address - Street 1:6711 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504
Practice Address - Country:US
Practice Address - Phone:951-352-3943
Practice Address - Fax:951-637-1577
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor