Individual provider Active NPI

Mary Leonen

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1083239628
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95149697 Issued in CA
Practice address
5530 Overland Ave Ste 210
San Diego, CA 92123-1261
Phone
(858) 694-3900
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95149697 CA Primary

Addresses

Primary practice location

5530 Overland Ave Ste 210
San Diego, CA 92123-1261

Mailing address

9586 Carroll Canyon Rd Apt 161
San Diego, CA 92126-4948
Phone (858) 609-9679

Other practice location 1

9586 Carroll Canyon Rd Apt 161
San Diego, CA 92126-4948
Phone (703) 398-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95149697CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1083239628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9586 CARROLL CANYON RD APT 161",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264948",
            "telephone_number": "858-609-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 OVERLAND AVE STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231261",
            "telephone_number": "858-694-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9586 Carroll Canyon Rd Apt 161",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921264948",
            "country_code": "US",
            "telephone_number": "703-398-3321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONEN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95149697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.