Provider Demographics
NPI:1982099156
Name:WOLFE, LEAH (OT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1222
Mailing Address - Country:US
Mailing Address - Phone:415-480-8011
Mailing Address - Fax:415-255-8211
Practice Address - Street 1:20 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1222
Practice Address - Country:US
Practice Address - Phone:415-480-8011
Practice Address - Fax:415-255-8211
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist