Individual provider Active NPI

Andrea Berenisse Leon, NP

  • Primary Care Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1306759253
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95041701 Issued in CA
Practice address
745 W 19TH St Ste F
Costa Mesa, CA 92627-3536
Phone
(949) 574-0210
NPI assigned
Sep 23, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95041701 CA Primary

Addresses

Primary practice location

745 W 19TH St Ste F
Costa Mesa, CA 92627-3536

Mailing address

745 W 19TH St Ste F
Costa Mesa, CA 92627-3536
Phone (949) 574-0210

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1306759253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W 19TH ST STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273536",
            "telephone_number": "949-574-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 W 19TH ST STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273536",
            "telephone_number": "949-574-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "ANDREA",
        "middle_name": "BERENISSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95041701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.