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General NPI Number Information
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NPI Number | 1669057766
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Entity Type | Individual
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Provider Name | EVA LEONEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 06/25/2022
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Provider Practice Location Address
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Address Line | 390 N PACIFIC COAST HWY STE 3000
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4486
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Country | US
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Telephone | 818-238-7081
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Fax |
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Provider Business Mailing Address
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Address Line | 19346 NORDHOFF ST
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2415
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Country | US
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Telephone | 818-727-2040
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95016906
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License Number State | CA
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