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General NPI Number Information
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NPI Number | 1659259349
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Entity Type | Individual
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Provider Name | JOHN WATSON PAUL LEBLANC NP
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Gender | Male
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 150 HARBOUR WAY STE 200
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City | RICHMOND
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State | CA
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Zip | 94801-3554
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Country | US
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Telephone | 510-981-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 50 CRESTLINE DR APT 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-1451
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Country | US
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Telephone | 860-930-9321
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95035689
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95035689
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License Number State | CA
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