Provider Demographics
NPI:1679245161
Name:LEONARD, DEBBIE ANN
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:ANN
Last Name:LEONARD
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 1:7709 EISENHOWER ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2478
Mailing Address - Country:US
Mailing Address - Phone:805-689-4980
Mailing Address - Fax:
Practice Address - Street 1:7709 EISENHOWER ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2478
Practice Address - Country:US
Practice Address - Phone:805-689-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95067580163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice