Healthcare Provider Details

I. General information

NPI: 1366227522
Provider Name (Legal Business Name): DAVID CHRISTOPHER LEISTEN MSN, AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

20 HUMBOLDT AVE
BURLINGTON MA
01803-3612
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1116
  • Fax:
Mailing address:
  • Phone: 585-301-7165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP95041357
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN2308219
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP95041357
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN2308219
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberNP95041357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: