Provider Demographics
NPI:1508133075
Name:NAVARRETE, SILVIA
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1686 DEL SUR BLVD
Mailing Address - Street 2:APT. 104
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-1332
Mailing Address - Country:US
Mailing Address - Phone:619-618-9487
Mailing Address - Fax:
Practice Address - Street 1:2930 CORONADO AVE
Practice Address - Street 2:SUITE D
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-2187
Practice Address - Country:US
Practice Address - Phone:619-618-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24206172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist