Healthcare Provider Details

I. General information

NPI: 1487566014
Provider Name (Legal Business Name): LEIGH ELAINA HULL CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 WINSTON DR
FAIRFIELD CA
94534-3018
US

IV. Provider business mailing address

2736 SEMINOLE CIR
FAIRFIELD CA
94534-7817
US

V. Phone/Fax

Practice location:
  • Phone: 707-421-4195
  • Fax:
Mailing address:
  • Phone: 707-344-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number38856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: