Provider Demographics
NPI:1700750858
Name:DE LEON, SHAHLA FISHER
Entity type:Individual
Prefix:
First Name:SHAHLA
Middle Name:FISHER
Last Name:DE LEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 HIDDEN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5417
Mailing Address - Country:US
Mailing Address - Phone:925-255-3132
Mailing Address - Fax:
Practice Address - Street 1:613 HIDDEN LAKES DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-5417
Practice Address - Country:US
Practice Address - Phone:925-255-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula