Provider Demographics
NPI:1881095834
Name:SILVA, NATALIE TALISTU (LMFT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:TALISTU
Last Name:SILVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:TALISTU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 W BRIGGSMORE AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-3839
Mailing Address - Country:US
Mailing Address - Phone:209-526-1440
Mailing Address - Fax:209-550-4903
Practice Address - Street 1:PO BOX 533
Practice Address - Street 2:
Practice Address - City:ESCALON
Practice Address - State:CA
Practice Address - Zip Code:95320-0533
Practice Address - Country:US
Practice Address - Phone:209-764-5272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CA110763106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional