Provider Demographics
NPI:1720261829
Name:LEONI, SHERRY (DC)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:
Last Name:LEONI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16542 VENTURA BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4562
Mailing Address - Country:US
Mailing Address - Phone:818-788-2400
Mailing Address - Fax:818-788-2453
Practice Address - Street 1:16542 VENTURA BLVD STE 402
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4562
Practice Address - Country:US
Practice Address - Phone:818-788-2400
Practice Address - Fax:818-788-2453
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor