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NPI Code Detail

MEDICARE: DR. ERNEST CLIFTON LEONARD PHD

MEDICARE: DR. ERNEST CLIFTON LEONARD PHD
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
1103TC0700XClinical PsychologistPSY7242CA

General Provider Information

NPI Number : 1447451083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERNEST CLIFTON LEONARD PHD
Provider Business Mailing Address
First Line : 1560 BOULDER RD
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-8823
Country : US
Telephone Number : 707-464-0015
Fax Number :
Provider Business Practice Location Address
First Line : PELICAN BAY STATE PRISON
Second Line : DEPT OF MENTAL HEALTH
City : CRESCENT CITY
State : CA
Zip : 95532-0001
Country : US
Telephone Number : 707-465-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 07/08/2007

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