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NPI Code Detail

MEDICARE: ANTHONY LEONARD

MEDICARE: ANTHONY LEONARD
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
1225800000XRecreation Therapist

General Provider Information

NPI Number : 1205790631
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY LEONARD
Provider Business Mailing Address
First Line : 1919 ADDISON ST STE 204
Second Line :
City : BERKELEY
State : CA
Zip : 94704-1143
Country : US
Telephone Number : 510-809-3004
Fax Number : 510-809-3240
Provider Business Practice Location Address
First Line : 1909 UNIVERSITY AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94704-1023
Country : US
Telephone Number : 510-809-3004
Fax Number : 510-809-3240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ ANTHONY LEONARD ” Practice Location

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