Provider Demographics
NPI:1417129099
Name:LEGGETT, HELEN REGINA (CATC-II)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:REGINA
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:CATC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6244 EL CAJON BLVD
Mailing Address - Street 2:STE 15
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3918
Mailing Address - Country:US
Mailing Address - Phone:619-287-8225
Mailing Address - Fax:619-287-4146
Practice Address - Street 1:6244 EL CAJON BLVD
Practice Address - Street 2:STE 15
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3918
Practice Address - Country:US
Practice Address - Phone:619-287-8225
Practice Address - Fax:619-287-4146
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA373781Medicaid