Healthcare Provider Details

I. General information

NPI: 1588211205
Provider Name (Legal Business Name): BETHANY TSAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N 1ST ST FL 2
SAN JOSE CA
95112-6312
US

IV. Provider business mailing address

2730 SHADELANDS DR BLDG 10
WALNUT CREEK CA
94598-2538
US

V. Phone/Fax

Practice location:
  • Phone: 925-266-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: