Provider Demographics
NPI:1538880190
Name:SUTHER, SILVIA HAYDEE (PPS)
Entity type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:HAYDEE
Last Name:SUTHER
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:MRS
Other - First Name:SILVIA
Other - Middle Name:HAYDEE
Other - Last Name:LUDENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:645 SERENADE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-2571
Mailing Address - Country:US
Mailing Address - Phone:408-608-9456
Mailing Address - Fax:
Practice Address - Street 1:645 SERENADE WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-2571
Practice Address - Country:US
Practice Address - Phone:408-608-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180122167103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty