Healthcare Provider Details

I. General information

NPI: 1811193063
Provider Name (Legal Business Name): SOURCEWISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DE LA CRUZ BLVD #310
SANTA CLARA CA
95054
US

IV. Provider business mailing address

3100 DE LA CRUZ BLVD #310
SANTA CLARA CA
95054
US

V. Phone/Fax

Practice location:
  • Phone: 408-350-3200
  • Fax: 855-965-0948
Mailing address:
  • Phone: 408-350-3200
  • Fax: 855-965-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ANELIZA DEL PINAL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 408-350-3231