Healthcare Provider Details

I. General information

NPI: 1295530376
Provider Name (Legal Business Name): DANIELLE POMILLA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2519 CHANDLER AVE
SIMI VALLEY CA
93065-0996
US

IV. Provider business mailing address

2519 CHANDLER AVE UNIT 1
SIMI VALLEY CA
93065-1960
US

V. Phone/Fax

Practice location:
  • Phone: 805-864-1387
  • Fax:
Mailing address:
  • Phone: 631-873-6974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: