Healthcare Provider Details

I. General information

NPI: 1033706890
Provider Name (Legal Business Name): LEAH HADDAD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH HADDAD TRELLA

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 S IVY AVE
MONROVIA CA
91016-2827
US

IV. Provider business mailing address

2025 N ORANGE OLIVE RD
ORANGE CA
92865-3326
US

V. Phone/Fax

Practice location:
  • Phone: 855-314-5625
  • Fax:
Mailing address:
  • Phone: 714-323-7716
  • Fax: 855-205-9679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95016323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: