Individual provider Active NPI

Julia Wedeles

  • Clinical Social Worker
  • Palo Alto, CA
National Provider Identifier
1083302376
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW106627 Issued in CA
Practice address
520 Sand Hill Rd
Packard Admin Suite
Palo Alto, CA 94304-2001
Phone
(408) 763-3880
NPI assigned
Apr 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW106627 CA Primary

Addresses

Primary practice location

520 Sand Hill Rd
Packard Admin Suite
Palo Alto, CA 94304-2001

Mailing address

337 Clifton Rd
Pacifica, CA 94044-1430
Phone (408) 763-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW106627CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1083302376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 CLIFTON RD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940441430",
            "telephone_number": "408-763-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SAND HILL RD",
            "address_2": "PACKARD ADMIN SUITE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042001",
            "telephone_number": "408-763-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDELES",
        "first_name": "JULIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW106627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.