Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT13737 | CA |
NPI | 1215203153 |
---|---|
Provider Name | Mrs. Julie Palana Wierzba |
First Address | Millbrae, CA 94030-1632 |
Second Address | Millbrae, CA 94030-1632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 30/12/2021 |