Healthcare Provider Details

I. General information

NPI: 1851651418
Provider Name (Legal Business Name): LEAH FRANKEL WILSON MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19000 HOMESTEAD RD BLDG. 1, 2ND FL.
CUPERTINO CA
95014-0712
US

IV. Provider business mailing address

200 WINCHESTER CIR APT C214
LOS GATOS CA
95032-1866
US

V. Phone/Fax

Practice location:
  • Phone: 408-366-4101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1000238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: