Provider Demographics
NPI:1053518761
Name:SILVERSTEIN, STANLEY JAY (PHD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JAY
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 WARNER AVE
Mailing Address - Street 2:#142
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-4659
Mailing Address - Country:US
Mailing Address - Phone:714-293-4857
Mailing Address - Fax:
Practice Address - Street 1:10101 SLATER AVE
Practice Address - Street 2:SUITE 237
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4733
Practice Address - Country:US
Practice Address - Phone:714-293-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5396103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral