Healthcare Provider Details

I. General information

NPI: 1427980093
Provider Name (Legal Business Name): IRIS PATRICIA LEON AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 E AVENUE Q10
PALMDALE CA
93550-4815
US

IV. Provider business mailing address

1854 E AVENUE Q9
PALMDALE CA
93550-5149
US

V. Phone/Fax

Practice location:
  • Phone: 213-245-5438
  • Fax: 213-245-5438
Mailing address:
  • Phone: 213-245-5438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: