Provider Demographics
NPI:1497805881
Name:BIERLEY, REX (PHD)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:
Last Name:BIERLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VETERANS BLVD
Mailing Address - Street 2:1400 BUILDING
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2037
Mailing Address - Country:US
Mailing Address - Phone:650-299-4782
Mailing Address - Fax:650-299-4335
Practice Address - Street 1:1150 VETERANS BLVD
Practice Address - Street 2:1400 BUILDING
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2037
Practice Address - Country:US
Practice Address - Phone:650-299-4782
Practice Address - Fax:650-299-4335
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11981103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist