Provider Demographics
NPI:1689721003
Name:SILVESTRI, MARY ANNE (LAC)
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:SILVESTRI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MARY ANNE
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4690 CARPINTERIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1870
Mailing Address - Country:US
Mailing Address - Phone:805-684-5012
Mailing Address - Fax:805-684-7225
Practice Address - Street 1:4690 CARPINTERIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1870
Practice Address - Country:US
Practice Address - Phone:805-684-5012
Practice Address - Fax:805-684-7225
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5183171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist