Healthcare Provider Details

I. General information

NPI: 1063335032
Provider Name (Legal Business Name): MEGAN LEONARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAN MARLO WAY STE 4
PACIFICA CA
94044-3274
US

IV. Provider business mailing address

1800 PACIFIC AVE APT 508
SAN FRANCISCO CA
94109-2398
US

V. Phone/Fax

Practice location:
  • Phone: 650-549-5015
  • Fax:
Mailing address:
  • Phone: 630-442-4125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number140002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: