Provider Demographics
NPI:1164133252
Name:BIANCHI, GIORGIO
Entity Type:Individual
Prefix:
First Name:GIORGIO
Middle Name:
Last Name:BIANCHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 EMBARCADERO STE 1-10
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5129
Mailing Address - Country:US
Mailing Address - Phone:510-541-5003
Mailing Address - Fax:
Practice Address - Street 1:1919 CUTTING BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-2662
Practice Address - Country:US
Practice Address - Phone:510-233-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20841225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist