Provider Demographics
NPI:1841952017
Name:SILVEIRA, RICHARD FRANK
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:FRANK
Last Name:SILVEIRA
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 1:2612 EL DORADO DR
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-3927
Mailing Address - Country:US
Mailing Address - Phone:209-606-7233
Mailing Address - Fax:
Practice Address - Street 1:1768 MITCHELL RD STE 301
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-2156
Practice Address - Country:US
Practice Address - Phone:209-353-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9072101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)