Provider Demographics
NPI:1174411615
Name:OVADIA, DANIELLE MIRIAM (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MIRIAM
Last Name:OVADIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23203 PARK CORNICHE
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2820
Mailing Address - Country:US
Mailing Address - Phone:818-723-0711
Mailing Address - Fax:
Practice Address - Street 1:5363 BALBOA BLVD STE 242
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2866
Practice Address - Country:US
Practice Address - Phone:818-723-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant