Provider Demographics
NPI:1316644958
Name:SILVA, LYDIA NICOLE
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:NICOLE
Last Name:SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19197 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1428
Mailing Address - Country:US
Mailing Address - Phone:505-615-4795
Mailing Address - Fax:
Practice Address - Street 1:22231 MULHOLLAND HWY STE 200
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5173
Practice Address - Country:US
Practice Address - Phone:818-222-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health