Provider Demographics
NPI:1659043131
Name:LEON, ANDREA M
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:LEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 TUSCANY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93927-5390
Mailing Address - Country:US
Mailing Address - Phone:831-613-3920
Mailing Address - Fax:
Practice Address - Street 1:1957 ARCADIA CT
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-5415
Practice Address - Country:US
Practice Address - Phone:831-287-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician