Provider Demographics
NPI:1790177863
Name:SZAVA, VERONIKA (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:VERONIKA
Middle Name:
Last Name:SZAVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:VERONIKA
Other - Middle Name:
Other - Last Name:SZAVA GLENISTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:300 TORINO DR APT 11
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-2859
Mailing Address - Country:US
Mailing Address - Phone:650-868-4485
Mailing Address - Fax:
Practice Address - Street 1:300 TORINO DR APT 11
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2859
Practice Address - Country:US
Practice Address - Phone:650-868-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT116680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist