Healthcare Provider Details

I. General information

NPI: 1740038140
Provider Name (Legal Business Name): BROOKE ELIZABETH LEONARD AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 SAND CREEK RD STE 125
BRENTWOOD CA
94513-2215
US

IV. Provider business mailing address

2731 GEARY BLVD APT C
SAN FRANCISCO CA
94118-3480
US

V. Phone/Fax

Practice location:
  • Phone: 415-362-5443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD4089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: