Provider Demographics
NPI:1891022117
Name:LEO, EMILY S (RN, CDE)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:LEO
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 POLLARD RD
Mailing Address - Street 2:STE. B205
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1415
Mailing Address - Country:US
Mailing Address - Phone:408-370-0330
Mailing Address - Fax:408-871-1210
Practice Address - Street 1:800 POLLARD RD
Practice Address - Street 2:STE. B205
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1415
Practice Address - Country:US
Practice Address - Phone:408-370-0330
Practice Address - Fax:408-871-1210
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153880163W00000X, 163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163W00000XNursing Service ProvidersRegistered Nurse