Provider Demographics
NPI:1083302376
Name:WEDELES, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:WEDELES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 CLIFTON RD
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-1430
Mailing Address - Country:US
Mailing Address - Phone:408-763-3880
Mailing Address - Fax:
Practice Address - Street 1:520 SAND HILL RD
Practice Address - Street 2:PACKARD ADMIN SUITE
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2001
Practice Address - Country:US
Practice Address - Phone:408-763-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1066271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical