Individual provider Active NPI

Beverly S Leonard, CPNP

  • Pediatric Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1285772392
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP10943 Issued in CA
Practice address
3705 Mission Blvd
San Diego, CA 92109-7104
Phone
(619) 515-2444
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP10943 CA Primary

Addresses

Primary practice location

3705 Mission Blvd
San Diego, CA 92109-7104

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623

Other practice location 1

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700 ext. 2678

Other practice location 2

1111 W Chase Ave
El Cajon, CA 92020-5710
Phone (691) 515-2499

Other practice location 3

251 Landis Ave
Chula Vista, CA 91910-2628
Phone (619) 515-2500

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002316 CA Practitioner - Nurse Practitioner 7012217680 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10943CAMDAddiction (Substance Use Disorder) Counselor
NP10943CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc CurrentSince Nov 16, 2015 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Nov 16, 2015 Accepting new patients

Locations

251 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2500

1111 W Chase Ave
El Cajon, CA 92020
Phone (619) 515-2499

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285772392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MISSION BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921097104",
            "telephone_number": "619-515-2444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-576-1700 x2678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 W Chase Ave",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920205710",
            "country_code": "US",
            "telephone_number": "691-515-2499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 Landis Ave",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919102628",
            "country_code": "US",
            "telephone_number": "619-515-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "BEVERLY",
        "middle_name": "S",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP10943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.