Provider Demographics
NPI:1104001510
Name:SILVA, TISH LEIONA (LCSW)
Entity Type:Individual
Prefix:
First Name:TISH
Middle Name:LEIONA
Last Name:SILVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2310
Mailing Address - Country:US
Mailing Address - Phone:510-725-8433
Mailing Address - Fax:510-350-3322
Practice Address - Street 1:508 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-4446
Practice Address - Country:US
Practice Address - Phone:925-549-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical