Doctor Name: | LEON BUENO |
NPI Number: | 1497175046 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 59546 |
Business Practice Address: | 144 S L St Dinuba, CA - 936182323 |
Business Phone Number: | 5595916680 |
Business Fax Number: | 5595916684 |
Mailing Address: | 144 S L St, DINUBA |
State: | CA |
Postal Code: | 936182323 |
Phone Number: | 5595916680 |
Fax Number: | 5595916684 |
NPI Enumeration Date: | 04/22/2014 |
NPI Last Update Date: | 04/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 59546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |