Provider Demographics
NPI:1598987224
Name:MASIFILO, SILILO TOMINIKO
Entity Type:Individual
Prefix:
First Name:SILILO
Middle Name:TOMINIKO
Last Name:MASIFILO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 FLYNN AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2926
Mailing Address - Country:US
Mailing Address - Phone:650-368-2435
Mailing Address - Fax:
Practice Address - Street 1:957 INDUSTRIAL RD STE B
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-4152
Practice Address - Country:US
Practice Address - Phone:415-375-1629
Practice Address - Fax:415-208-0010
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health