Provider Demographics
NPI:1861764326
Name:LEAHY, SONJA (FNP)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:LEAHY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:
Other - Last Name:SKENDZIC-KELLOGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:23861 MCBEAN PKWY STE A4
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2003
Mailing Address - Country:US
Mailing Address - Phone:661-202-3248
Mailing Address - Fax:661-888-1270
Practice Address - Street 1:23861 MCBEAN PKWY STE A4
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2003
Practice Address - Country:US
Practice Address - Phone:661-202-3248
Practice Address - Fax:661-888-1270
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN18385363LF0000X
CA18385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily