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NPI Code Detail

MEDICARE: CHALEEN WHITE-LEACH

MEDICARE: CHALEEN WHITE-LEACH
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#5339CA

General Provider Information

NPI Number : 1962854687
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHALEEN WHITE-LEACH
Provider Business Mailing Address
First Line : 1342 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3266
Country : US
Telephone Number : 510-535-0611
Fax Number : 510-535-1658
Provider Business Practice Location Address
First Line : 1342 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-3266
Country : US
Telephone Number : 510-535-0611
Fax Number : 510-535-1658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2016
Last Update Date : 07/06/2016

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Directions to “ CHALEEN WHITE-LEACH ” Practice Location

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