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General NPI Number Information
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NPI Number | 1447003074
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Entity Type | Individual
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Provider Name | OLEN LEON
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Gender | Male
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 299 12TH ST STE B
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City | MARINA
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State | CA
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Zip | 93933-6003
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Country | US
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Telephone | 831-620-2726
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Fax | 831-883-3032
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Provider Business Mailing Address
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Address Line | 1024 HAMILTON AVE
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City | SEASIDE
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State | CA
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Zip | 93955-5210
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Country | US
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Telephone | 831-883-3030
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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