Provider Demographics
NPI:1790459998
Name:LEVITT, ARIELA JOELLE
Entity Type:Individual
Prefix:
First Name:ARIELA
Middle Name:JOELLE
Last Name:LEVITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOELLE
Other - Middle Name:MILO
Other - Last Name:LEVITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18008 SKY PARK CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1545 SAWTELLE BLVD STE 31
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3272
Practice Address - Country:US
Practice Address - Phone:646-620-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician