Healthcare Provider Details

I. General information

NPI: 1588587141
Provider Name (Legal Business Name): DR. DEWANA LEISHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEWANA KIRKMAN

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 COMMERCIAL XING
SANTA CRUZ CA
95065-1702
US

IV. Provider business mailing address

149 ZINFANDEL CIR
SCOTTS VALLEY CA
95066-3258
US

V. Phone/Fax

Practice location:
  • Phone: 831-460-6689
  • Fax:
Mailing address:
  • Phone: 831-332-8269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: