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NPI Code Detail

MEDICARE: LEANNE KELLY GREENBERG

MEDICARE: LEANNE KELLY GREENBERG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2106H00000XMarriage & Family Therapist125678CA

General Provider Information

NPI Number : 1053559658
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANNE KELLY GREENBERG
Provider Business Mailing Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 858-427-5060
Fax Number :
Provider Business Practice Location Address
First Line : 5060 SHOREHAM PL STE 330
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-5976
Country : US
Telephone Number : 858-427-5060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2009
Last Update Date : 07/06/2021

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Directions to “ LEANNE KELLY GREENBERG ” Practice Location

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