Provider Demographics
NPI:1184746356
Name:LEON, JONAH (CCP)
Entity type:Individual
Prefix:MR
First Name:JONAH
Middle Name:
Last Name:LEON
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SANTANA ROW
Mailing Address - Street 2:SUITE 313
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2000
Mailing Address - Country:US
Mailing Address - Phone:650-815-1920
Mailing Address - Fax:650-615-9995
Practice Address - Street 1:333 SANTANA ROW
Practice Address - Street 2:SUITE 313
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2000
Practice Address - Country:US
Practice Address - Phone:650-815-1920
Practice Address - Fax:650-615-9995
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA029055242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist