Provider Demographics
NPI:1043402266
Name:MACHTMES, LESLIE ELAINE (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ELAINE
Last Name:MACHTMES
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 VIA ROBLE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2925
Mailing Address - Country:US
Mailing Address - Phone:925-962-1088
Mailing Address - Fax:
Practice Address - Street 1:755 S VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1908
Practice Address - Country:US
Practice Address - Phone:415-642-4522
Practice Address - Fax:415-642-4529
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist