Provider Demographics
NPI:1942576350
Name:SILVA, MARCELINA JASMINE (DO)
Entity Type:Individual
Prefix:
First Name:MARCELINA JASMINE
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:D O
Mailing Address - Street 1:450 N WIGET LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2408
Mailing Address - Country:US
Mailing Address - Phone:925-482-8151
Mailing Address - Fax:925-482-1166
Practice Address - Street 1:450 N WIGET LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2408
Practice Address - Country:US
Practice Address - Phone:925-482-8151
Practice Address - Fax:925-482-1166
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13068208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN