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INGRID LECKLITER PH.D.

Clinical Neuropsychologist

Sacramento, California

Provider NPI: 1518940238

Provider Information:
 INGRID  LECKLITER PH.D.
Gender: F


Practice Location:
2825 50TH ST UCDHS- M.I.N.D. INSTUTUTE SACRAMENTO, CA 95817 US
Tel: 916-703-0255  Fax: 916-703-0243

Business Mailing Address:
2825 50TH ST UCDHS- M.I.N.D. INSTUTUTE SACRAMENTO, CA 95817 US
Tel: 916-703-0255  Fax: 916-703-0243

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CAPSY 17240

Other Provider Identifiers:

IssuerNumberStateType
UCDHS PROVIDER #007980ACA01
PSYCHOLOGIST LICENSE #0665OR01
MEDI-CAL GROUP NUMBERGR002104MCA01
PSYCHOLOGIST LICENSEPSY 17240CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS CA - Page 1

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