Provider Demographics
NPI:1891559647
Name:LEAP, EMILY ELIZABETH (DAOM, LAC, LMT)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ELIZABETH
Last Name:LEAP
Suffix:
Gender:F
Credentials:DAOM, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CROXTON AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5728
Mailing Address - Country:US
Mailing Address - Phone:510-654-6500
Mailing Address - Fax:
Practice Address - Street 1:15 CROXTON AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5728
Practice Address - Country:US
Practice Address - Phone:510-654-6500
Practice Address - Fax:510-788-5545
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18023171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty