Provider Demographics
NPI:1619162260
Name:LEONE, ANDREW JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:LEONE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 VALLEY VIEW RD APT 27
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1773
Mailing Address - Country:US
Mailing Address - Phone:415-519-5961
Mailing Address - Fax:
Practice Address - Street 1:10940 WILSHIRE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3940
Practice Address - Country:US
Practice Address - Phone:415-519-5961
Practice Address - Fax:714-352-6471
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32516103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical