Provider Demographics
NPI:1346742996
Name:SILVEIRA, JARED
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:SILVEIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 CORIANDER WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4932
Mailing Address - Country:US
Mailing Address - Phone:209-423-3729
Mailing Address - Fax:
Practice Address - Street 1:665 CORIANDER WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-4932
Practice Address - Country:US
Practice Address - Phone:209-423-3729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician