Provider Demographics
NPI:1710268685
Name:RANDA, LEIGH ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ANNE
Last Name:RANDA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 S COLLEGE LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2342
Mailing Address - Country:US
Mailing Address - Phone:971-601-0748
Mailing Address - Fax:
Practice Address - Street 1:8515 S COLLEGE LN
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2342
Practice Address - Country:US
Practice Address - Phone:858-224-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA28028103TC0700X
AZ4597103TC0700X
IA001237103TC0700X
MO2017008027103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist