Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY5662 | CA |
N | 103T00000X | Psychologist | PSY5662 | CA |
N | 103G00000X | Clinical Psychologist | PSY5662 | CA |
N | 103TC0700X | Clinical Psychologist | PSY5662 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY5662 | CA |
NPI | 1053300897 |
---|---|
Provider Name | Dr. Gerald M. Silver |
First Address | Sonoma, CA 95476-3023 |
Second Address | Sonoma, CA 95476-6519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 09/07/2007 |