Provider Demographics
NPI:1811584915
Name:STREIGHTIFF, SYLVAN
Entity Type:Individual
Prefix:
First Name:SYLVAN
Middle Name:
Last Name:STREIGHTIFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 D ST
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3802
Mailing Address - Country:US
Mailing Address - Phone:619-890-8569
Mailing Address - Fax:
Practice Address - Street 1:1925 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1037
Practice Address - Country:US
Practice Address - Phone:408-508-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141080106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist