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General NPI Number Information
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NPI Number | 1881417087
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Entity Type | Individual
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Provider Name | CHRISTY DENISE LEONARD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 1127 S 38TH ST
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City | SAN DIEGO
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State | CA
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Zip | 92113-3210
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Country | US
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Telephone | 619-262-4002
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Fax |
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Provider Business Mailing Address
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Address Line | 2746 BRIGHTON COURT RD UNIT 3
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City | CHULA VISTA
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State | CA
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Zip | 91915-2629
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1588111124
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License Number State | CA
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