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General NPI Number Information
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NPI Number | 1073665113
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Entity Type | Individual
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Provider Name | LEONARD JOSEPH WESTON PH D
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 42525 RANCHO MIRAGE LANE 5682 THE HISTORIC PLAZA
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City | 29 PALMS
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State | CA
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Zip | 92277-1743
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Country | US
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Telephone | 760-367-0411
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Fax | 760-341-1333
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Provider Business Mailing Address
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Address Line | 72 810 AMBROSIA STREET
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City | PALM DESERT
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State | CA
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Zip | 92260-5971
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Country | US
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Telephone | 760-880-2002
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Fax | 760-341-1333
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 5789
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License Number State | CA
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