Healthcare Provider Details

I. General information

NPI: 1659333664
Provider Name (Legal Business Name): DEVELOPMENT IS CHILD'S PLAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10011 N FOOTHILL BLVD SUITE 109
CUPERTINO CA
95014-5649
US

IV. Provider business mailing address

10011 N FOOTHILL BLVD SUITE 109
CUPERTINO CA
95014-5649
US

V. Phone/Fax

Practice location:
  • Phone: 408-865-1365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 2912
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License NumberOT 2912
License Number StateCA

VIII. Authorized Official

Name: MS. TERI WISS
Title or Position: DIRECTOR
Credential:
Phone: 408-865-1365