Provider Demographics
NPI:1609183144
Name:LEFEVER, DANIELLE LUKE (OD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LUKE
Last Name:LEFEVER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LUKE
Other - Last Name:CUDAHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 WEEOT WAY
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4734
Mailing Address - Country:US
Mailing Address - Phone:707-825-5000
Mailing Address - Fax:707-825-6747
Practice Address - Street 1:434 7TH ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1803
Practice Address - Country:US
Practice Address - Phone:707-296-2500
Practice Address - Fax:707-443-3548
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14063152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGQ990ZMedicare PIN