Provider Demographics
NPI:1376009639
Name:GREENBERG, WENDY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4358
Mailing Address - Country:US
Mailing Address - Phone:925-209-4694
Mailing Address - Fax:
Practice Address - Street 1:1190 BURNETT AVE STE D
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5612
Practice Address - Country:US
Practice Address - Phone:925-209-4694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA985410225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics