Basic Information
| Provider Information | |||||||||
| NPI: | 1235359639 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SILVA | ||||||||
| FirstName: | LENORE | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | NARVY (ALSO, LONGENECKER) | ||||||||
| OtherFirstName: | LENORE | ||||||||
| OtherMiddleName: | ROSE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2635 LAVERY CT | ||||||||
| Address2: | #1 | ||||||||
| City: | NEWBURY PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913201517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054998273 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1305 DEL NORTE RD | ||||||||
| Address2: | |||||||||
| City: | CAMARILLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930108436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054856114 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | IMF41756 | CA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.