Healthcare Provider Details

I. General information

NPI: 1619862141
Provider Name (Legal Business Name): MS. LEEANDRA MARIE DUPZYK - DIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49370 ROAD 426 STE B
OAKHURST CA
93644-9052
US

IV. Provider business mailing address

49370 ROAD 426 STE B
OAKHURST CA
93644-9052
US

V. Phone/Fax

Practice location:
  • Phone: 559-641-6321
  • Fax:
Mailing address:
  • Phone: 559-641-6321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: