Provider Demographics
NPI:1184371767
Name:KARL, LEAH NOEL (RDHAP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:NOEL
Last Name:KARL
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7195 SANTA YSABEL AVE
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4561
Mailing Address - Country:US
Mailing Address - Phone:805-332-6989
Mailing Address - Fax:
Practice Address - Street 1:503 13TH ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2226
Practice Address - Country:US
Practice Address - Phone:805-400-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA890124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist