Provider Demographics
NPI:1124580956
Name:LEONE, VIRGINIA ANNE (MD, MPH)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ANNE
Last Name:LEONE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2579 OLD QUARRY RD APT 2333
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2787
Mailing Address - Country:US
Mailing Address - Phone:781-724-4487
Mailing Address - Fax:
Practice Address - Street 1:17340 YOLO AVE
Practice Address - Street 2:
Practice Address - City:ESPARTO
Practice Address - State:CA
Practice Address - Zip Code:95627-2265
Practice Address - Country:US
Practice Address - Phone:530-787-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine