Basic Information
| Provider Information | |||||||||
| NPI: | 1770913485 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEONARDO | ||||||||
| FirstName: | DARREN | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | I | ||||||||
| Credential: | CAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2087 | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953440087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093816880 | ||||||||
| FaxNumber: | 2097236220 | ||||||||
| Practice Location | |||||||||
| Address1: | 3313 G ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953400991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093816880 | ||||||||
| FaxNumber: | 2097236220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2013 | ||||||||
| LastUpdateDate: | 02/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 02-138605 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.