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NPI Code Detail

MEDICARE: GENERATION SENSE, LLC

MEDICARE: GENERATION SENSE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD1600XDevelopmental Disabilities Clinic/Center

General Provider Information

NPI Number : 1124516786
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATION SENSE, LLC
Provider Business Mailing Address
First Line : 1290 LAWRENCE STATION RD
Second Line :
City : SUNNYVALE
State : CA
Zip : 94089-2220
Country : US
Telephone Number : 408-743-5332
Fax Number :
Provider Business Practice Location Address
First Line : 2580 LAFAYETTE ST
Second Line :
City : SANTA CLARA
State : CA
Zip : 95050-2602
Country : US
Telephone Number : 408-743-5332
Fax Number : 408-743-5676
Authorized Official
Title or Position : CEO
Name : TANNIA CISNEROS
Credential : OTR/L
Telephone Number : 305-298-8205
Provider Enumeration Date : 04/28/2018
Last Update Date : 09/11/2024

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