Provider Demographics
NPI:1659333664
Name:DEVELOPMENT IS CHILD'S PLAY
Entity Type:Organization
Organization Name:DEVELOPMENT IS CHILD'S PLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:WISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-865-1365
Mailing Address - Street 1:10011 N FOOTHILL BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10011 N FOOTHILL BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5649
Practice Address - Country:US
Practice Address - Phone:408-865-1365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 2912225X00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Not Answered261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty