Healthcare Provider Details

I. General information

NPI: 1558673699
Provider Name (Legal Business Name): SILICON VALLEY ABA AND CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 S MAIN ST STE 103
MILPITAS CA
95035-6295
US

IV. Provider business mailing address

1613 S MAIN ST STE 103
MILPITAS CA
95035-6295
US

V. Phone/Fax

Practice location:
  • Phone: 408-476-3208
  • Fax:
Mailing address:
  • Phone: 408-476-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberHS0724
License Number StateCA

VIII. Authorized Official

Name: MISS ALMA GUINTO BAYANI
Title or Position: CLINICAL DIRECTOR
Credential: PSY.D
Phone: 408-476-3208