Provider Demographics
NPI:1588022446
Name:AUBERT, LEONARD DUANE (CADC-CAS)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:DUANE
Last Name:AUBERT
Suffix:
Gender:M
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 ILLINOIS ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-3058
Mailing Address - Country:US
Mailing Address - Phone:619-515-2588
Mailing Address - Fax:619-269-8349
Practice Address - Street 1:3928 ILLINOIS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3058
Practice Address - Country:US
Practice Address - Phone:619-515-2588
Practice Address - Fax:619-269-8349
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC15511214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)