Provider Demographics
NPI:1033313051
Name:LEONARD, SARA LEAH (MA)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:LEAH
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20305 CANYONVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TUOLUMNE
Mailing Address - State:CA
Mailing Address - Zip Code:95379-9737
Mailing Address - Country:US
Mailing Address - Phone:209-928-5946
Mailing Address - Fax:
Practice Address - Street 1:12801 CABEZUT RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5938
Practice Address - Country:US
Practice Address - Phone:209-533-3553
Practice Address - Fax:209-536-9528
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist