Healthcare Provider Details

I. General information

NPI: 1316857592
Provider Name (Legal Business Name): BIBIANA GARCIA LEON
Entity Type: Individual
Gender: Female
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

751 RANCHEROS DR STE 5
SAN MARCOS CA
92069-3042
US

IV. Provider business mailing address

751 RANCHEROS DR STE 5
SAN MARCOS CA
92069-3042
US

V. Phone/Fax

Practice location:
  • Phone: 760-761-0515
  • Fax: 760-761-0464
Mailing address:
  • Phone: 760-761-0515
  • Fax: 760-761-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: