Provider Demographics
NPI:1649323817
Name:SILES, ERIC PETER
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:PETER
Last Name:SILES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18852 PATRICIAN DR
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861-4213
Mailing Address - Country:US
Mailing Address - Phone:714-351-2651
Mailing Address - Fax:
Practice Address - Street 1:2416 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3255
Practice Address - Country:US
Practice Address - Phone:714-966-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health