Provider Demographics
NPI:1427937465
Name:LEON ACASIETE, DEIVY J
Entity type:Individual
Prefix:
First Name:DEIVY
Middle Name:J
Last Name:LEON ACASIETE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 E CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3050
Mailing Address - Country:US
Mailing Address - Phone:562-500-2480
Mailing Address - Fax:
Practice Address - Street 1:1776 E CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3050
Practice Address - Country:US
Practice Address - Phone:562-500-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95419910163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management