Provider Demographics
NPI:1851265946
Name:DONOVAN, EILEEN (LCSW, PPSC, CWA)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LCSW, PPSC, CWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 FIDDLERS GRN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-3014
Mailing Address - Country:US
Mailing Address - Phone:650-526-3500
Mailing Address - Fax:
Practice Address - Street 1:1400 MONTECITO AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4590
Practice Address - Country:US
Practice Address - Phone:650-526-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2500546241041S0200X
CA1319151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool