Healthcare Provider Details

I. General information

NPI: 1861361479
Provider Name (Legal Business Name): SUVI TIKKA SILVANTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 AVALON DR
SOUTH SAN FRANCISCO CA
94080-5558
US

IV. Provider business mailing address

140 FAIRMOUNT ST
SAN FRANCISCO CA
94131-2716
US

V. Phone/Fax

Practice location:
  • Phone: 415-712-2328
  • Fax:
Mailing address:
  • Phone: 415-712-2328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number154494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: