Provider Demographics
NPI:1457127961
Name:SILVA, SARAH (CMT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 W KETTLEMAN LN STE A5
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-4217
Mailing Address - Country:US
Mailing Address - Phone:209-327-0060
Mailing Address - Fax:
Practice Address - Street 1:1826 W KETTLEMAN LN STE A5
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-4217
Practice Address - Country:US
Practice Address - Phone:209-327-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist