Provider Demographics
NPI:1033995840
Name:MORALES, LESLEY M
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:M
Last Name:MORALES
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 1:13817 MESA VIEW DR # A
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-3710
Mailing Address - Country:US
Mailing Address - Phone:657-321-6193
Mailing Address - Fax:
Practice Address - Street 1:13817 MESA VIEW DR # A
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-3710
Practice Address - Country:US
Practice Address - Phone:657-321-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician