Healthcare Provider Details

I. General information

NPI: 1851265946
Provider Name (Legal Business Name): EILEEN DONOVAN LCSW, PPSC, CWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MONTECITO AVE
MOUNTAIN VIEW CA
94043-4590
US

IV. Provider business mailing address

1219 FIDDLERS GRN
SAN JOSE CA
95125-3014
US

V. Phone/Fax

Practice location:
  • Phone: 650-526-3500
  • Fax:
Mailing address:
  • Phone: 650-526-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number250054624
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: