1942535174 NPI number — MRS. KATHRYN JOANNE MORIN SILVA LCSW

Table of content: MRS. KATHRYN JOANNE MORIN SILVA LCSW (NPI 1942535174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942535174 NPI number — MRS. KATHRYN JOANNE MORIN SILVA LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVA
Provider First Name:
KATHRYN
Provider Middle Name:
JOANNE MORIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SILVA
Provider Other First Name:
JO
Provider Other Middle Name:
MORIN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942535174
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 80711
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RANCHO SANTA MARGARITA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92688-0711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-350-5320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24441 HEALTH CENTER DRIVE
Provider Second Line Business Practice Location Address:
SUITE 680
Provider Business Practice Location Address City Name:
LAGUNA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-350-5320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  LCS23541 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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