Provider Demographics
NPI:1801334339
Name:HARRISON, LEIGHNA NOELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:LEIGHNA
Middle Name:NOELLE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 MORAGA AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3906
Mailing Address - Country:US
Mailing Address - Phone:310-462-1774
Mailing Address - Fax:
Practice Address - Street 1:1300 CLAY ST STE 600
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1427
Practice Address - Country:US
Practice Address - Phone:650-382-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28827103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical