Active NPI
Leon Samuel Mancilla
- Peer Specialist
- San Diego, CA
National Provider Identifier
1376140590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 5555 Reservoir Dr
San Diego, CA 92120-5134 - Phone
- (619) 822-1800
- NPI assigned
- Oct 1, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
5555 Reservoir Dr
San Diego, CA 92120-5134
Mailing address
5555 Reservoir Dr
San Diego, CA 92120-5134
Phone (619) 822-1800
Other names 1
- Leon Samuel Loeb-Mancilla
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | leon.mancilla@mhsinc.org | Direct | |
| Direct Messaging Address | leon.mancilla@mhsinc.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1376140590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134",
"telephone_number": "619-822-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134",
"telephone_number": "619-822-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCILLA",
"first_name": "LEON",
"middle_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-01",
"last_updated": "2020-10-01",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "leon.mancilla@mhsinc.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "5555 Reservoir Dr",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921205134",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "leon.mancilla@mhsinc.org",
"affiliation": "N",
"address_1": "5555 Reservoir Dr",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921205134",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LEON",
"last_name": "LOEB-MANCILLA",
"middle_name": "SAMUEL",
"code": "1",
"type": "Former Name"
}
]
}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 Oct 1, 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.