Provider Demographics
NPI:1053527986
Name:LEVINE, EMILY REBECCA (OTR/L, C/NDT, SWC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:REBECCA
Last Name:LEVINE
Suffix:
Gender:F
Credentials:OTR/L, C/NDT, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13115 MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2158
Mailing Address - Country:US
Mailing Address - Phone:818-385-1628
Mailing Address - Fax:
Practice Address - Street 1:11340 W OLYMPIC BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064
Practice Address - Country:US
Practice Address - Phone:310-268-7880
Practice Address - Fax:310-268-7881
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1637225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics