=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235827007
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SILICON VALLEY THERAPY AND MARRIAGE COUNSELING SERVICES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2023
-----------------------------------------------------
Last Update Date | 02/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16615 LARK AVE STE 100
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-7645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-990-2827
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16615 LARK AVE STE 100
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-7645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-990-2827
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & FOUNDER
-----------------------------------------------------
Name | NICHOLAS SANCHEZ
-----------------------------------------------------
Credential | MA, LMFT
-----------------------------------------------------
Telephone | 408-410-7076
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------