Basic Information
| Provider Information | |||||||||
| NPI: | 1619013307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEALAO | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | VILLANUEVA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 299 12TH ST STE A | ||||||||
| Address2: | MONTEREY COUNTY BEHAVIORAL HEALTH | ||||||||
| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939336003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316477652 | ||||||||
| FaxNumber: | 8316477940 | ||||||||
| Practice Location | |||||||||
| Address1: | 299 12TH ST STE A | ||||||||
| Address2: | MONTEREY COUNTY BEHAVIORAL HEALTH | ||||||||
| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939336003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316477652 | ||||||||
| FaxNumber: | 8316477940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 03/26/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.