Provider Demographics
NPI:1679509434
Name:SILVA, CHARYL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARYL
Middle Name:MARIE
Last Name:SILVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3304
Mailing Address - Country:US
Mailing Address - Phone:916-372-8383
Mailing Address - Fax:916-372-8588
Practice Address - Street 1:1044 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3304
Practice Address - Country:US
Practice Address - Phone:916-372-8383
Practice Address - Fax:916-372-8588
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 19605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0196050Medicare ID - Type UnspecifiedMEDICARE ID#