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General NPI Number Information
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NPI Number | 1023496379
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Entity Type | Individual
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Provider Name | STEVEN LEONARD II SUDCC
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Gender | Male
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 500 N 9TH ST STE B
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City | MODESTO
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State | CA
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Zip | 95350-5814
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Country | US
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Telephone | 209-525-7412
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Fax |
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Provider Business Mailing Address
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Address Line | 1904 RICHALND AVE
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City | CERES
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State | CA
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Zip | 95307
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Country | US
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Telephone | 209-541-2088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | AII8911214
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | AII7891214
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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