Individual provider Active NPI

Yulissa Ponce

  • Day Training/Habilitation Specialist
  • San Bruno, CA
National Provider Identifier
1083420533
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
Practice address
931 San Bruno Ave W RM 2
San Bruno, CA 94066-3435
Phone
(650) 832-6797
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Day Training/Habilitation Specialist 373H00000X Primary

Addresses

Primary practice location

931 San Bruno Ave W RM 2
San Bruno, CA 94066-3435

Mailing address

931 San Bruno Ave W RM 2
San Bruno, CA 94066-3435

Other practice location 1

700 Airport Blvd Ste 495
Burlingame, CA 94010-1945
Phone (650) 517-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1083420533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W RM 2",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SAN BRUNO AVE W RM 2",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663435",
            "telephone_number": "650-832-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Airport Blvd Ste 495",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "940101945",
            "country_code": "US",
            "telephone_number": "650-517-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONCE",
        "first_name": "YULISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.