Healthcare Provider Details

I. General information

NPI: 1972412112
Provider Name (Legal Business Name): STEVEN DESILVA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 S EL CAMINO REAL
SAN MATEO CA
94403-1854
US

IV. Provider business mailing address

421 N 10TH ST
SAN JOSE CA
95112-3328
US

V. Phone/Fax

Practice location:
  • Phone: 650-539-3345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: