Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY 13597 | CA |
Y | 103T00000X | Psychologist | PSY 13597 | CA |
NPI | 1003911470 |
---|---|
Provider Name | Dr. Bradley Dean Silverman |
First Address | Trabuco Canyon, CA 92679-1613 |
Second Address | Trabuco Canyon, CA 92679-1613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |