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General NPI Number Information
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NPI Number | 1790192649
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Entity Type | Individual
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Provider Name | JANELLE RENEE LEYONE OT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 1291 CRAIG AVE
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City | LAKEPORT
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State | CA
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Zip | 95453-5704
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Country | US
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Telephone | 707-263-6382
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 S 209TH PL APT C306
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City | SEATAC
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State | WA
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Zip | 98198-4339
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Country | US
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Telephone | 619-218-2978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1424
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119-007554
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License Number State | VA
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