NPI Code Details Logo

NPI 1457283673

NPI 1457283673 : NICOLETTE LEFFLER RD : COSTA MESA, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1457283673
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    NICOLETTE LEFFLER RD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/01/2026
-----------------------------------------------------
    Last Update Date     |    06/01/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    267 HANOVER DR 
-----------------------------------------------------
    City                 |    COSTA MESA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92626-6173
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    949-342-4020
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    267 HANOVER DR 
-----------------------------------------------------
    City                 |    COSTA MESA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92626-6173
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    949-342-4020
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    171400000X
-----------------------------------------------------
    Taxonomy Name        |    Health & Wellness Coach
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    133V00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Dietitian
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.