Individual provider Active NPI

Mariya A. Leontyeva, FNP-C

  • Family Nurse Practitioner
  • San Mateo, CA
National Provider Identifier
1649037094
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028520 Issued in CA
Practice address
34 N San Mateo Dr # 2
San Mateo, CA 94401-2824
Phone
(650) 513-6651
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028520 CA Primary

Addresses

Primary practice location

34 N San Mateo Dr # 2
San Mateo, CA 94401-2824

Mailing address

34 N San Mateo Dr # 2
San Mateo, CA 94401-2824
Phone (650) 513-6651

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

LicenseStateTypeSpecialty
95028520CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1649037094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 N SAN MATEO DR # 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012824",
            "telephone_number": "650-513-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N SAN MATEO DR # 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012824",
            "telephone_number": "650-513-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONTYEVA",
        "first_name": "MARIYA",
        "middle_name": "A.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.