Provider Demographics
NPI:1316453756
Name:RANKIN, LEAH KRISTINE (CCL PROGRAM ADMIN)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:KRISTINE
Last Name:RANKIN
Suffix:
Gender:F
Credentials:CCL PROGRAM ADMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W DEL NORTE ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-2815
Mailing Address - Country:US
Mailing Address - Phone:707-798-7192
Mailing Address - Fax:
Practice Address - Street 1:2370 BUHNE ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3237
Practice Address - Country:US
Practice Address - Phone:707-442-5721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6055323735376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator