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NPI Code Detail

MEDICARE: DESIREE DELEON

MEDICARE: DESIREE DELEON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1205223500
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE DELEON
Provider Business Mailing Address
First Line : 2307 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3119
Country : US
Telephone Number : 213-351-2800
Fax Number :
Provider Business Practice Location Address
First Line : 2307 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3119
Country : US
Telephone Number : 213-351-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2015
Last Update Date : 03/03/2016

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Directions to “ DESIREE DELEON ” Practice Location

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