Provider Demographics
NPI:1720478506
Name:LEON FRANCO, LAURA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LEON FRANCO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:LEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:1401 PARKMOOR AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3407
Mailing Address - Country:US
Mailing Address - Phone:408-241-9911
Mailing Address - Fax:800-656-5079
Practice Address - Street 1:1401 PARKMOOR AVE STE 208
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3407
Practice Address - Country:US
Practice Address - Phone:408-241-9911
Practice Address - Fax:800-656-5079
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-17397103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst