Provider Demographics
NPI:1427106905
Name:LEONE, JACOB KYLE (ND)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:KYLE
Last Name:LEONE
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:448 IGNACIO BLVD # 294
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6085
Mailing Address - Country:US
Mailing Address - Phone:415-484-1240
Mailing Address - Fax:866-484-0518
Practice Address - Street 1:1748 NOVATO BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947
Practice Address - Country:US
Practice Address - Phone:415-484-1240
Practice Address - Fax:866-484-0518
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAND-219175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath