Provider Demographics
NPI:1033835665
Name:LEON, ALEJANDRA ANGELINA
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:ANGELINA
Last Name:LEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4138 IRENE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-1425
Mailing Address - Country:US
Mailing Address - Phone:925-228-9414
Mailing Address - Fax:
Practice Address - Street 1:4138 IRENE DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1425
Practice Address - Country:US
Practice Address - Phone:925-812-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician