Provider Demographics
NPI:1619028263
Name:SILBERT, DENISE TERRI (RN, CNS, PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:TERRI
Last Name:SILBERT
Suffix:
Gender:F
Credentials:RN, CNS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5478 SOLEDAD RD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7044
Mailing Address - Country:US
Mailing Address - Phone:858-483-1430
Mailing Address - Fax:
Practice Address - Street 1:5478 SOLEDAD RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7044
Practice Address - Country:US
Practice Address - Phone:858-483-1430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1407103T00000X
CACNS100364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS61184Medicare UPIN
CACNS100Medicare ID - Type UnspecifiedMEDICARE