Provider Demographics
NPI:1265822399
Name:SHULMAN, DANIELLE (OT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11172 CORTE PLENO VERANO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2688
Mailing Address - Country:US
Mailing Address - Phone:858-401-2677
Mailing Address - Fax:
Practice Address - Street 1:11172 CORTE PLENO VERANO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2688
Practice Address - Country:US
Practice Address - Phone:858-401-2677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1050816225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics