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General NPI Number Information
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NPI Number | 1699396119
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Entity Type | Individual
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Provider Name | TAL LEEAD PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 5923 KANAN RD
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1688
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Country | US
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Telephone | 818-575-7057
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Fax |
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Provider Business Mailing Address
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Address Line | 29934 TRIUNFO DR
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City | AGOURA HILLS
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State | CA
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Zip | 91301-3016
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Country | US
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Telephone | 818-451-9207
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY15971
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License Number State | CA
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