Provider Demographics
NPI:1629262159
Name:LEARY, ALONDRA MONIQUE (BS)
Entity Type:Individual
Prefix:
First Name:ALONDRA
Middle Name:MONIQUE
Last Name:LEARY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 VIA CARTAGO APT 104
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6260
Mailing Address - Country:US
Mailing Address - Phone:951-488-5335
Mailing Address - Fax:
Practice Address - Street 1:41870 KALMIA ST
Practice Address - Street 2:STE. 165
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8839
Practice Address - Country:US
Practice Address - Phone:951-696-3501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor