Provider Demographics
NPI:1215904339
Name:ADVENTIST HEALTH SILVERADO PSYCHIATRIC CLINIC
Entity type:Organization
Organization Name:ADVENTIST HEALTH SILVERADO PSYCHIATRIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL GROUP MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-968-2870
Mailing Address - Street 1:3273 CLAREMONT WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3306
Mailing Address - Country:US
Mailing Address - Phone:707-252-1720
Mailing Address - Fax:707-258-0328
Practice Address - Street 1:3273 CLAREMONT WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3306
Practice Address - Country:US
Practice Address - Phone:707-252-1720
Practice Address - Fax:707-258-0328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ43093ZMedicare ID - Type Unspecified