Healthcare Provider Details

I. General information

NPI: 1396665808
Provider Name (Legal Business Name): DANIELLE JACLYN LEVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 W AVENIDA DE LOS ARBOLES
THOUSAND OAKS CA
91360-2939
US

IV. Provider business mailing address

67 EVERETT ST
MARSHFIELD MA
02050-5459
US

V. Phone/Fax

Practice location:
  • Phone: 805-492-2444
  • Fax:
Mailing address:
  • Phone: 339-832-2563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: