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General NPI Number Information
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NPI Number | 1669704177
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Entity Type | Organization
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Legal Business Name | STEPPING STONES CENTER FOR AUTISTIC SPECTRUM DISORDERS, INC.
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 3190 CLEARVIEW WAY SUITE 103
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City | SAN MATEO
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State | CA
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Zip | 94402-3752
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Country | US
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Telephone | 650-357-0571
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Fax |
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Provider Business Mailing Address
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Address Line | 3190 CLEARVIEW WAY SUITE 103
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City | SAN MATEO
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State | CA
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Zip | 94402-3752
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Country | US
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Telephone | 650-357-0571
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Fax |
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Authorized Official
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Title or Position | OWNER AND CLINICAL DIRECTOR
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Name | VIVIAN DAVID-NICOLAS
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Credential |
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Telephone | 650-357-0571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1084557
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP11976
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 1A41040
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License Number State | CA
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