Healthcare Provider Details

I. General information

NPI: 1992669923
Provider Name (Legal Business Name): RONALD JOHN DELEON DNP, CNS, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21101 SUNDOWN LN
HUNTINGTON BEACH CA
92648-5430
US

IV. Provider business mailing address

21101 SUNDOWN LN
HUNTINGTON BEACH CA
92648-5430
US

V. Phone/Fax

Practice location:
  • Phone: 619-885-1572
  • Fax:
Mailing address:
  • Phone: 619-885-1572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number638809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: