Individual provider Active NPI

Janelle Renee Leyone, OT

  • Occupational Therapist
  • Lakeport, CA
National Provider Identifier
1790192649
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119-007554 Issued in VA
Practice address
1291 Craig Ave
Lakeport, CA 95453-5704
Phone
(707) 263-6382
NPI assigned
Jul 11, 2014
Reactivated
Oct 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1424 CA
Occupational Therapist 225X00000X 0119-007554 VA Primary

Addresses

Primary practice location

1291 Craig Ave
Lakeport, CA 95453-5704

Mailing address

3750 S 209TH PL Apt C306
Seatac, WA 98198-4339
Phone (619) 218-2978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1424CAMDOccupational Therapist
0119-007554VAMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1790192649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 S 209TH PL APT C306",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981984339",
            "telephone_number": "619-218-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 CRAIG AVE",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535704",
            "telephone_number": "707-263-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYONE",
        "first_name": "JANELLE",
        "middle_name": "RENEE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2018-10-09",
        "deactivation_date": "2015-02-10",
        "reactivation_date": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "1424",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119-007554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.