Provider Demographics
NPI:1164102174
Name:LEON, VERONICA MARIE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MARIE
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 1:140 S C ST
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-4822
Mailing Address - Country:US
Mailing Address - Phone:559-334-6410
Mailing Address - Fax:
Practice Address - Street 1:140 S C ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-4822
Practice Address - Country:US
Practice Address - Phone:559-334-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula