Provider Demographics
NPI:1508392127
Name:DORN, LEAH KATHLEEN-JORDAN (ATC)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:KATHLEEN-JORDAN
Last Name:DORN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:KATHLEEN-JORDAN
Other - Last Name:TURCOTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:6712 SOMERSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-4124
Mailing Address - Country:US
Mailing Address - Phone:916-992-4853
Mailing Address - Fax:
Practice Address - Street 1:6712 SOMERSWORTH DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4124
Practice Address - Country:US
Practice Address - Phone:916-992-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000239702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer