Provider Demographics
NPI:1265715460
Name:MCDONALD, MARIKA LEANDRA (CBD, CBE)
Entity type:Individual
Prefix:MRS
First Name:MARIKA
Middle Name:LEANDRA
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CBD, CBE
Other - Prefix:MS
Other - First Name:MARIKA
Other - Middle Name:LEANDRA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:632 BONITA CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6522
Mailing Address - Country:US
Mailing Address - Phone:707-342-1996
Mailing Address - Fax:
Practice Address - Street 1:100 ADMIRAL CALLAGHAN LN
Practice Address - Street 2:NO. 5543
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-4023
Practice Address - Country:US
Practice Address - Phone:707-342-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula