Provider Demographics
NPI:1568142867
Name:SILICON VALLEY NUTRITION AND PERFORMANCE
Entity Type:Organization
Organization Name:SILICON VALLEY NUTRITION AND PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADZIMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-509-5346
Mailing Address - Street 1:530 LAWRENCE EXPY UNIT 9035
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2790 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-3007
Practice Address - Country:US
Practice Address - Phone:408-663-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health