Provider Demographics
NPI:1942727755
Name:SILVEIRA, TRACY LORRAINE (MS/MFCT, MFTI)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LORRAINE
Last Name:SILVEIRA
Suffix:
Gender:F
Credentials:MS/MFCT, MFTI
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:LORRAINE
Other - Last Name:SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3195 M ST.
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-237-6030
Mailing Address - Fax:209-723-6032
Practice Address - Street 1:3195 M ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2406
Practice Address - Country:US
Practice Address - Phone:209-723-6030
Practice Address - Fax:209-723-6032
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT100542101YM0800X, 106H00000X
CAIMFT100542104100000X
1041C0700X, 106H00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator