Provider Demographics
NPI:1417323163
Name:LEON, DANIELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 AVENIDA HACIENDA
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4225
Mailing Address - Country:US
Mailing Address - Phone:310-918-3733
Mailing Address - Fax:
Practice Address - Street 1:11332 CAMARILLO ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1217
Practice Address - Country:US
Practice Address - Phone:310-918-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7242225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics