Individual
MS. LEANDRA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11150 HIGHWAY 1, POINT REYES STATION, CA 94956-9756
(415) 663-1082
(415) 663-9474
Mailing address
20 FLEETWOOD CT, NOVATO, CA 94947-3751
(415) 663-1082
(415) 663-9474
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95003190
CA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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