Provider Demographics
NPI:1366055329
Name:SANCHEZ ESPINOZA, LEONARDO ALEXANDER
Entity type:Individual
Prefix:
First Name:LEONARDO ALEXANDER
Middle Name:
Last Name:SANCHEZ ESPINOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 CARLSON ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-7320
Mailing Address - Country:US
Mailing Address - Phone:707-457-2727
Mailing Address - Fax:
Practice Address - Street 1:440 CARLSON ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-7320
Practice Address - Country:US
Practice Address - Phone:707-457-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant