Provider Demographics
NPI:1235688334
Name:LECLERC, LEAH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:LECLERC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SHARON PARK DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6805
Mailing Address - Country:US
Mailing Address - Phone:650-854-4636
Mailing Address - Fax:650-854-4815
Practice Address - Street 1:325 SHARON PARK DR
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6805
Practice Address - Country:US
Practice Address - Phone:650-854-4636
Practice Address - Fax:650-854-4815
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68538183500000X
RI4322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist