Organization Active NPI

Judy de Leon

  • Community/Behavioral Health Agency
  • Campbell, CA
National Provider Identifier
1073774170
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MFC 41569 Issued in CA
Legal business name
JUDY DE LEON
Practice address
3425 S Bascom Ave
Suite F
Campbell, CA 95008-7300
Phone
(408) 595-5258
NPI assigned
Jun 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Judy De Leon, LMFT
Title
Marriage Family Therapist
Phone
(408) 595-5258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MFC 41569 CA Primary

Addresses

Primary practice location

3425 S Bascom Ave
Suite F
Campbell, CA 95008-7300

Mailing address

3425 S Bascom Ave
Suite F
Campbell, CA 95008-7300
Phone (408) 595-5258

Other identifiers 1

IdentifierTypeStateIssuer
1043388598OtherCAGARDNER FA MILY CARE CORP.

National Provider Directory

National Provider Directory

Locations

3425 S Bascom Ave
Ste F
Campbell, CA 95008
Phone (408) 307-0901

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1073774170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE",
            "address_2": "SUITE F",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-595-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE",
            "address_2": "SUITE F",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-595-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY DE LEON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "MARRIAGE FAMILY THERAPIST",
        "authorized_official_telephone_number": "408-595-5258",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC 41569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GARDNER FA MILY CARE CORP.",
            "identifier": "1043388598",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.