Healthcare Provider Details

I. General information

NPI: 1053489526
Provider Name (Legal Business Name): DR. LEANN C. SKIMMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 CENTER DR
LA MESA CA
91942-3034
US

IV. Provider business mailing address

4794 CAMINITO EVANGELICO
SAN DIEGO CA
92130-2471
US

V. Phone/Fax

Practice location:
  • Phone: 800-257-8715
  • Fax:
Mailing address:
  • Phone: 858-259-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number18048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: