Provider Demographics
NPI:1386370872
Name:SILVA, SERENA MAY (MFT ASSOCIATE)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:MAY
Last Name:SILVA
Suffix:
Gender:F
Credentials:MFT ASSOCIATE
Other - Prefix:
Other - First Name:SERENE
Other - Middle Name:MAY
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1006 KING ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3515
Mailing Address - Country:US
Mailing Address - Phone:831-291-3693
Mailing Address - Fax:
Practice Address - Street 1:1001 CENTER ST STE 6
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3796
Practice Address - Country:US
Practice Address - Phone:831-291-3693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist