Active NPI
Leasza Provenzano
- Student in an Organized Health Care Education/Training Program
- San Ramon, CA
National Provider Identifier
1497197032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 130 Reflections Dr, #25
San Ramon, CA 94583 - Phone
- (510) 776-8303
- NPI assigned
- Jul 24, 2013
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
130 Reflections Dr, #25
San Ramon, CA 94583
Mailing address
130 Reflections Dr Apt 25
San Ramon, CA 94583-4725
Phone (510) 776-8303
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": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1497197032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 REFLECTIONS DR APT 25",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834725",
"telephone_number": "510-776-8303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 REFLECTIONS DR, #25",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "94583",
"telephone_number": "510-776-8303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVENZANO",
"first_name": "LEASZA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.