Healthcare Provider Details

I. General information

NPI: 1023928207
Provider Name (Legal Business Name): JOHN MICHAEL LEONARDO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 FLINT AVE
SAN JOSE CA
95148-1719
US

IV. Provider business mailing address

2450 W BAYSHORE RD APT 7
PALO ALTO CA
94303-3522
US

V. Phone/Fax

Practice location:
  • Phone: 510-557-0374
  • Fax:
Mailing address:
  • Phone: 650-283-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-534701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: