Healthcare Provider Details

I. General information

NPI: 1013906080
Provider Name (Legal Business Name): JULIE WILLIAMSON M.O.T., OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BON AIR RD SUITE A105
LARKSPUR CA
94939-1143
US

IV. Provider business mailing address

5 BON AIR RD SUITE A105
LARKSPUR CA
94939-1143
US

V. Phone/Fax

Practice location:
  • Phone: 415-927-2007
  • Fax: 415-927-7272
Mailing address:
  • Phone: 415-927-2007
  • Fax: 415-927-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOT5103
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT5103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: