Healthcare Provider Details

I. General information

NPI: 1588298236
Provider Name (Legal Business Name): LEAH A YESHNIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 3506
VISTA CA
92085-3506
US

IV. Provider business mailing address

120 W HAWTHORNE ST
FALLBROOK CA
92028-2053
US

V. Phone/Fax

Practice location:
  • Phone: 760-731-3235
  • Fax:
Mailing address:
  • Phone: 760-731-3235
  • Fax: 760-432-9953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number156451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: