Healthcare Provider Details

I. General information

NPI: 1518458165
Provider Name (Legal Business Name): SEAN PATRICK LEONARD PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 OCEAN RANCH BLVD STE 208&209
OCEANSIDE CA
92056-2698
US

IV. Provider business mailing address

3609 OCEAN RANCH BLVD STE 208&209
OCEANSIDE CA
92056-2698
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax: 858-467-7161
Mailing address:
  • Phone: 858-279-1223
  • Fax: 858-467-7161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95009094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: