Active NPI
Susan Grace Leckband, RPH, BCPP
- Psychiatric Pharmacist
- La Jolla, CA
National Provider Identifier
1306843206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 47907
- Practice address
- 3350 La Jolla Village Dr
119
La Jolla, CA 92037-1806 - Phone
- (858) 552-8585
- Fax
- (858) 552-4336
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 47907 | CA | Primary |
Addresses
Primary practice location
3350 La Jolla Village Dr
119
La Jolla, CA 92037-1806
Mailing address
3350 La Jolla Village Dr
119
La Jolla, CA 92037-1806
Phone (858) 552-8585
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47907 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306843206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"address_2": "119",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371806",
"telephone_number": "858-552-8585",
"fax_number": "858-552-4336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 LA JOLLA VILLAGE DR",
"address_2": "119",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371806",
"telephone_number": "858-552-8585",
"fax_number": "858-552-4336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECKBAND",
"first_name": "SUSAN",
"middle_name": "GRACE",
"name_prefix": "Ms.",
"credential": "RPH, BCPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "CA",
"license": "47907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.