Active NPI
Yulissa Ponce
- Day Training/Habilitation Specialist
- San Bruno, CA
National Provider Identifier
1083420533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.