MEDICARE: ANGELA LEONARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1134665532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA LEONARD

Provider Business Mailing Address
First Line	:	28253 FOXLANE DR
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-1238
Country	:	US
Telephone Number	:	323-467-8466
Fax Number	:	323-488-6400

Provider Business Practice Location Address
First Line	:	1853 TAFT AVE
Second Line	:
City	:	HOLLYWOOD
State	:	CA
Zip	:	90028-5706
Country	:	US
Telephone Number	:	323-467-8466
Fax Number	:	323-488-6400

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2017
Last Update Date	:	01/10/2017

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Directions to “ ANGELA LEONARD ” Practice Location

Language	Start Address	Practice Location

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