Provider Demographics
NPI:1669691853
Name:SILVA, ADRIAN LUPE (CATC)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:LUPE
Last Name:SILVA
Suffix:
Gender:M
Credentials:CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 E HOME AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-4129
Mailing Address - Country:US
Mailing Address - Phone:559-260-1215
Mailing Address - Fax:
Practice Address - Street 1:14277 ROAD 28
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-5715
Practice Address - Country:US
Practice Address - Phone:559-675-7920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA051100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)