Healthcare Provider Details

I. General information

NPI: 1053272104
Provider Name (Legal Business Name): DANIEL JANULAITIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 3343
SANTA MONICA CA
90408-3343
US

IV. Provider business mailing address

1217 WILSHIRE BLVD P.O BOX 3343
SANTA MONICA CA
90403
US

V. Phone/Fax

Practice location:
  • Phone: 310-853-0188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number134423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: