Provider Demographics
NPI:1497755508
Name:LEONARD, WENDY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:206 SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4419
Mailing Address - Country:US
Mailing Address - Phone:831-688-2030
Mailing Address - Fax:
Practice Address - Street 1:1430 FREEDOM BLVD STE D
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2752
Practice Address - Country:US
Practice Address - Phone:831-763-8400
Practice Address - Fax:831-763-8127
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA67597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BL6860096OtherDEA
CA00A675970Medicare ID - Type Unspecified
BL6860096OtherDEA