Provider Demographics
NPI:1417830043
Name:DLEON, ELISE
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:DLEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 CECIL PL
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-1817
Mailing Address - Country:US
Mailing Address - Phone:949-330-0355
Mailing Address - Fax:
Practice Address - Street 1:4281 KATELLA AVE STE 207
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6515
Practice Address - Country:US
Practice Address - Phone:626-270-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist