Provider Demographics
NPI:1962807149
Name:LEONARDO, MARIA CECILIA
Entity type:Individual
Prefix:
First Name:MARIA CECILIA
Middle Name:
Last Name:LEONARDO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GOLDEN GATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3706
Mailing Address - Country:US
Mailing Address - Phone:510-356-7450
Mailing Address - Fax:
Practice Address - Street 1:230 GOLDEN GATE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3706
Practice Address - Country:US
Practice Address - Phone:625-754-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132367106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist