Provider Demographics
NPI:1063571842
Name:LEIGH, VINCENTA MARY (RN, MSN, CS)
Entity type:Individual
Prefix:MRS
First Name:VINCENTA
Middle Name:MARY
Last Name:LEIGH
Suffix:
Gender:F
Credentials:RN, MSN, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12535 MOFFATT LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-9703
Mailing Address - Country:US
Mailing Address - Phone:559-434-0452
Mailing Address - Fax:413-793-4503
Practice Address - Street 1:4785 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0513
Practice Address - Country:US
Practice Address - Phone:559-448-4731
Practice Address - Fax:559-448-4867
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 440939364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health