Healthcare Provider Details

I. General information

NPI: 1053594770
Provider Name (Legal Business Name): ALEXANDRIA LEEDY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRIA PIERINI

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 QUEEN ST STE 100
HONOLULU HI
96814-4130
US

IV. Provider business mailing address

95-390 KUAHELANI AVE STE 3AC
MILILANI HI
96789-1190
US

V. Phone/Fax

Practice location:
  • Phone: 808-672-2024
  • Fax:
Mailing address:
  • Phone: 808-672-2024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY21744
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY21744
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY21744
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: