Healthcare Provider Details

I. General information

NPI: 1386036648
Provider Name (Legal Business Name): LEAH MYHANH BARDEN MS.EDUCATION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31946 MISSION TRL SUITE B
LAKE ELSINORE CA
92530-4539
US

IV. Provider business mailing address

31946 MISSION TRL STE B
LAKE ELSINORE CA
92530-4539
US

V. Phone/Fax

Practice location:
  • Phone: 951-245-7663
  • Fax: 951-674-6431
Mailing address:
  • Phone: 951-245-7663
  • Fax: 951-674-6431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: