Provider Demographics
NPI:1134622756
Name:VERDUGO, SILVIA
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:VERDUGO
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 1:724 S 1ST ST APT 4
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-1664
Mailing Address - Country:US
Mailing Address - Phone:559-567-8931
Mailing Address - Fax:
Practice Address - Street 1:7339 N 1ST ST # 105110
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2954
Practice Address - Country:US
Practice Address - Phone:888-512-2695
Practice Address - Fax:916-729-3006
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician