David Vernon Silva, LCSW

Key facts

NPI

1699345280

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

25153 (CA)

Practice address

3645 S Emily St
San Pedro, CA 90731-6447

Phone

(415) 320-4517

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sud Specialty Group - Ca Addiction Medicine (Psychiatry & Neurology) Physician · Santa Clara, CA · NPI 1972138238
  Medicare reassignment NPD CA
• Toiyabe Indian Health Project, Inc Federally Qualified Health Center (FQHC) · Bishop, CA · NPI 1659433191
  Medicare reassignment NPD CA
• Toiyabe Indian Health Project, Inc Clinic Pharmacy · Bishop, CA · NPI 1093720609
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Addresses

Other names

• Vernon Silva Professional name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 28, 2021.

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1699345280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6518",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907346518",
            "telephone_number": "415-320-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 S EMILY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316447",
            "telephone_number": "415-320-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "DAVID VERNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "25153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERNON",
            "last_name": "SILVA",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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All providers in San Pedro, CA · Mental Health Counselor in California