Provider Demographics
NPI:1568266658
Name:LEPTICH, KIRSTEN MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MICHELLE
Last Name:LEPTICH
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:MICHELLE
Other - Last Name:JOHANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 W IMPERIAL HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:955 W IMPERIAL HWY STE 110
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3814
Practice Address - Country:US
Practice Address - Phone:714-449-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95200581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse