Provider Demographics
NPI:1104455849
Name:LEONG, EVELYN ACUNA
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:ACUNA
Last Name:LEONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 E VIA ESTRELLA DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-8828
Mailing Address - Country:US
Mailing Address - Phone:559-434-2126
Mailing Address - Fax:
Practice Address - Street 1:1281 E VIA ESTRELLA DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93730-8828
Practice Address - Country:US
Practice Address - Phone:559-434-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629118163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse