Provider Demographics
NPI:1750059945
Name:SILKA, ELLEN
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:SILKA
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 1:2751 MERLONE CT
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-5668
Mailing Address - Country:US
Mailing Address - Phone:310-795-8983
Mailing Address - Fax:
Practice Address - Street 1:2685 MARINE WAY STE 1316
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1119
Practice Address - Country:US
Practice Address - Phone:408-915-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health