Active NPI
Jonathan Walden Leonard
- Marriage & Family Therapist
- San Leandro, CA
National Provider Identifier
1396357695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT121241
- Practice address
- 400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962 - Phone
- (510) 352-9200
- NPI assigned
- Aug 18, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT121241 | CA | Primary |
Addresses
Primary practice location
400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Mailing address
400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone (510) 352-9200
Other practice location 1
545 Estudillo Ave
San Leandro, CA 94577-4611
Phone (510) 352-9200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT121241 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1396357695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 ESTUDILLO AVE STE 100",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774962",
"telephone_number": "510-352-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 ESTUDILLO AVE STE 100",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774962",
"telephone_number": "510-352-9200"
}
],
"practiceLocations": [
{
"address_1": "545 Estudillo Ave",
"address_purpose": "LOCATION",
"city": "San Leandro",
"state": "CA",
"postal_code": "945774611",
"country_code": "US",
"telephone_number": "510-352-9200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEONARD",
"first_name": "JONATHAN",
"middle_name": "WALDEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-18",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT121241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.