Active NPI
Constance Primrose De Silva, MD
- Psychiatry Physician
- Orange, CA
National Provider Identifier
1912922634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A 33450
- Practice address
- 810 W la Veta Ave
Orange, CA 92868-3918 - Phone
- (715) 532-6811
- Fax
- (714) 532-5487
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A 33450 | CA | Primary |
Addresses
Primary practice location
810 W la Veta Ave
Orange, CA 92868-3918
Mailing address
810 W la Veta Ave
Orange, CA 92868-3918
Phone (715) 532-6811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WA 33450M | Other | CA | PPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A 33450 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192752000000",
"number": "1912922634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683918",
"telephone_number": "715-532-6811",
"fax_number": "714-532-5487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683918",
"telephone_number": "715-532-6811",
"fax_number": "714-532-5487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SILVA",
"first_name": "CONSTANCE",
"middle_name": "PRIMROSE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A 33450",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "WA 33450M",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.