Provider Demographics
NPI:1386363018
Name:SILVA, JOCYNTHIA DE JESUS (FNP)
Entity type:Individual
Prefix:
First Name:JOCYNTHIA
Middle Name:DE JESUS
Last Name:SILVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOSYNTHIA
Other - Middle Name:DE JESUS
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1456 E LUGONIA AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2715
Mailing Address - Country:US
Mailing Address - Phone:909-685-6386
Mailing Address - Fax:
Practice Address - Street 1:802 W COLTON AVE STE E
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2905
Practice Address - Country:US
Practice Address - Phone:909-335-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95022168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty