Provider Demographics
NPI:1770089948
Name:TIMBANG, LEAH ANDREA PEL
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ANDREA PEL
Last Name:TIMBANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 STOCKTON BLVD
Mailing Address - Street 2:NORTH ADDITION 5TH FLOOR
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1529
Mailing Address - Country:US
Mailing Address - Phone:916-734-2816
Mailing Address - Fax:
Practice Address - Street 1:2335 STOCKTON BLVD
Practice Address - Street 2:NORTH ADDITION 5TH FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1529
Practice Address - Country:US
Practice Address - Phone:916-734-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program