Healthcare Provider Details

I. General information

NPI: 1760243836
Provider Name (Legal Business Name): HEAR PSYCHOTHERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 07/09/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 SUNRISE BLVD STE 120359
RANCHO CORDOVA CA
95742-6911
US

IV. Provider business mailing address

4022 SUNRISE BLVD STE 120359
RANCHO CORDOVA CA
95742-6911
US

V. Phone/Fax

Practice location:
  • Phone: 916-314-3264
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN LEAZENBY
Title or Position: PRESIDENT
Credential: PSYD
Phone: 916-314-3264