Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Everardo Leon

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1770211666

Everardo Leon is a Clinical Psychologist in San Quentin, California. Qualified in 2023, 3 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2022
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Practice location Address checks out

100 Main St
San Quentin, CA 94964
Phone: (415) 250-7289
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1770211666
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 10, 2022
Last updated in NPPESAugust 18, 2022
Certification dateAugust 17, 2022
Mailing address1173 Grizzly Peak Blvd, Berkeley, CA 94708-1740

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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