Active NPI
Colleen Jane Leon, IDC
- Independent Duty Corpsman
- San Diego, CA
National Provider Identifier
1760814875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- Surface Warfare Medical Institute
34101 Farenholt Avenue, Building 14
San Diego, CA 92134-5291 - Phone
- (619) 532-6195
- NPI assigned
- Jul 31, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
Surface Warfare Medical Institute
34101 Farenholt Avenue, Building 14
San Diego, CA 92134-5291
Mailing address
Surface Warfare Medical Institute
34101 Farenholt Avenue, Building 14
San Diego, CA 92134-5291
Phone (619) 532-6195
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": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1760814875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SURFACE WARFARE MEDICAL INSTITUTE",
"address_2": "34101 FARENHOLT AVENUE, BUILDING 14",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921345291",
"telephone_number": "619-532-6195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SURFACE WARFARE MEDICAL INSTITUTE",
"address_2": "34101 FARENHOLT AVENUE, BUILDING 14",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921345291",
"telephone_number": "619-532-6195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "COLLEEN",
"middle_name": "JANE",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 31, 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.