Provider Demographics
NPI:1912105305
Name:WENEGRAT, ANNE O'REILLY (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:O'REILLY
Last Name:WENEGRAT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 FIFE AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3029
Mailing Address - Country:US
Mailing Address - Phone:650-324-2683
Mailing Address - Fax:
Practice Address - Street 1:935 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3339
Practice Address - Country:US
Practice Address - Phone:650-327-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13765103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical