Provider Demographics
NPI:1164141297
Name:LEAL, SIERRAH R (BA)
Entity Type:Individual
Prefix:
First Name:SIERRAH
Middle Name:R
Last Name:LEAL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 THRUSH DR
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-9008
Mailing Address - Country:US
Mailing Address - Phone:209-620-7549
Mailing Address - Fax:
Practice Address - Street 1:1100 PEDRAS RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2363
Practice Address - Country:US
Practice Address - Phone:209-620-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst