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General NPI Number Information
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NPI Number | 1083302376
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Entity Type | Individual
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Provider Name | JULIA WEDELES
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Gender | Female
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 520 SAND HILL RD PACKARD ADMIN SUITE
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City | PALO ALTO
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State | CA
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Zip | 94304-2001
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Country | US
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Telephone | 408-763-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 337 CLIFTON RD
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City | PACIFICA
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State | CA
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Zip | 94044-1430
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Country | US
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Telephone | 408-763-3880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW106627
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License Number State | CA
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