Provider Demographics
NPI:1821742420
Name:SHARPE, LELAND PEDRO (EMT)
Entity Type:Individual
Prefix:
First Name:LELAND
Middle Name:PEDRO
Last Name:SHARPE
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 W BULLARD AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1603
Mailing Address - Country:US
Mailing Address - Phone:559-906-9763
Mailing Address - Fax:
Practice Address - Street 1:2960 S CHERRY AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-5445
Practice Address - Country:US
Practice Address - Phone:800-255-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic