Healthcare Provider Details

I. General information

NPI: 1265318372
Provider Name (Legal Business Name): ILEA (LEO) HARRINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEO HARRINGTON

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

IV. Provider business mailing address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-5955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: