Individual provider Active NPI

John Fannin Leckie, PH.D

  • Counseling Psychologist
  • Vacaville, CA
National Provider Identifier
1255321444
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
30801 Issued in CA
Practice address
1600 California Drive
Vacaville, CA 95696-1800
Phone
(707) 448-6841
NPI assigned
Oct 27, 2005
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 30801 CA Primary

Addresses

Primary practice location

1600 California Drive
Vacaville, CA 95696-1800

Mailing address

PO Box 4413
Davis, CA 95617-4413
Phone (530) 220-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731002185 CA Practitioner - Clinical Psychologist 5890006589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total Life Ca PCGroup PAC ID 3173989332, 34 clinicians

Practice addresses (Care Compare)

6080 Ctr Dr
FL 6
Los Angeles, CA 90045-9205
Phone (800) 567-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
30801CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Life Ca, P.C. Counseling CurrentSince Jul 1, 2025 Accepting new patients

Locations

6080 Center Dr
Fl 6
Westchester, CA 90045
Phone (669) 231-6870

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1255321444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4413",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956174413",
            "telephone_number": "530-220-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CALIFORNIA DRIVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956961800",
            "telephone_number": "707-448-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECKIE",
        "first_name": "JOHN",
        "middle_name": "FANNIN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "30801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.