Provider Demographics
NPI:1255909537
Name:HEBERT, LELAND RAY II
Entity type:Individual
Prefix:
First Name:LELAND
Middle Name:RAY
Last Name:HEBERT
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58967 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7308
Mailing Address - Country:US
Mailing Address - Phone:760-369-3130
Mailing Address - Fax:
Practice Address - Street 1:58967 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7308
Practice Address - Country:US
Practice Address - Phone:760-369-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner