Healthcare Provider Details

I. General information

NPI: 1184073710
Provider Name (Legal Business Name): HEALTH EDUCATION ADVOCACY LEADERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2016
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4276 54TH PL STE C
SAN DIEGO CA
92115-6011
US

IV. Provider business mailing address

31670 FOX GRAPE DR
WINCHESTER CA
92596-9503
US

V. Phone/Fax

Practice location:
  • Phone: 619-501-5511
  • Fax:
Mailing address:
  • Phone: 619-501-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. DARLING PAUL-RICHIEZ
Title or Position: PRESIDENT & CEO
Credential: DNP, MSPH, FNP-BC
Phone: 619-501-5511