Provider Demographics
NPI:1902192461
Name:DELGADILLO, LEAH JEAN (RKT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JEAN
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:RKT
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:JEAN
Other - Last Name:JAKUBOWSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RKT
Mailing Address - Street 1:1874 E WOODGATE DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1952
Mailing Address - Country:US
Mailing Address - Phone:562-826-5556
Mailing Address - Fax:
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist