Healthcare Provider Details

I. General information

NPI: 1124896279
Provider Name (Legal Business Name): MARSHA LEVY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S PATTERSON AVE
SANTA BARBARA CA
93111-2006
US

IV. Provider business mailing address

2201 NW 55TH TER
LAUDERHILL FL
33313-3231
US

V. Phone/Fax

Practice location:
  • Phone: 805-964-4871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number6548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: