Provider Demographics
NPI:1144598970
Name:WEIR, SIERRA DULLEA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:DULLEA
Last Name:WEIR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 SACRAMENTO STREET
Mailing Address - Street 2:3
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1120
Mailing Address - Country:US
Mailing Address - Phone:510-610-4610
Mailing Address - Fax:415-358-7457
Practice Address - Street 1:3220 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-2726
Practice Address - Country:US
Practice Address - Phone:510-766-0132
Practice Address - Fax:415-358-7457
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist