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General NPI Number Information
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NPI Number | 1164018826
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Entity Type | Organization
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Legal Business Name | LEADING PUBLIC HEALTH ENTERPRISES, INC.
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 8732 S SEPULVEDA BLVD FL 2
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City | LOS ANGELES
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State | CA
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Zip | 90045-4031
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Country | US
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Telephone | 831-200-2774
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Fax | 323-968-0006
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Provider Business Mailing Address
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Address Line | 400 CORPORATE POINTE STE 300
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City | CULVER CITY
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State | CA
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Zip | 90230-7620
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Country | US
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Telephone | 831-200-3774
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Fax | 323-968-0006
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. JESSICA SAINT-PAUL
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Credential | DMSC, PA, MPH
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Telephone | 831-200-3774
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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