Provider Demographics
NPI:1215203153
Name:WIERZBA, JULIE PALANA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:PALANA
Last Name:WIERZBA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RICHMOND DR APT 12
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1632
Mailing Address - Country:US
Mailing Address - Phone:650-296-6629
Mailing Address - Fax:
Practice Address - Street 1:400 RICHMOND DR APT 12
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1632
Practice Address - Country:US
Practice Address - Phone:650-296-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT13737225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation