Provider Demographics
NPI:1992015499
Name:LEONARD, KAMI AMBER (MA)
Entity Type:Individual
Prefix:MS
First Name:KAMI
Middle Name:AMBER
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21201 VICTORY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2866
Mailing Address - Country:US
Mailing Address - Phone:818-754-2593
Mailing Address - Fax:818-887-7842
Practice Address - Street 1:21201 VICTORY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303
Practice Address - Country:US
Practice Address - Phone:818-754-2593
Practice Address - Fax:818-887-7842
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51713106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist