Provider Demographics
NPI:1457995128
Name:WU, PRISCA (OTR/L)
Entity type:Individual
Prefix:
First Name:PRISCA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PRISCA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23586 CALABASAS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1330
Mailing Address - Country:US
Mailing Address - Phone:818-224-3837
Mailing Address - Fax:
Practice Address - Street 1:23586 CALABASAS RD STE 206
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1330
Practice Address - Country:US
Practice Address - Phone:818-224-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist