Provider Demographics
NPI:1588379226
Name:PEAKS AND VALLEYS PRN LLC
Entity type:Organization
Organization Name:PEAKS AND VALLEYS PRN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBER
Authorized Official - Suffix:
Authorized Official - Credentials:CMF, LCSW
Authorized Official - Phone:804-938-1032
Mailing Address - Street 1:2237 LAGOON VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1505
Mailing Address - Country:US
Mailing Address - Phone:804-938-1032
Mailing Address - Fax:
Practice Address - Street 1:741 GARDEN VIEW CT STE 208
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2472
Practice Address - Country:US
Practice Address - Phone:760-585-5408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty