Healthcare Provider Details

I. General information

NPI: 1871044651
Provider Name (Legal Business Name): LEAH SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CALIFORNIA ST
RODEO CA
94572-1311
US

IV. Provider business mailing address

4032 WEBSTER ST
OAKLAND CA
94609-2515
US

V. Phone/Fax

Practice location:
  • Phone: 602-330-9408
  • Fax:
Mailing address:
  • Phone: 602-330-9408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: