Provider Demographics
NPI:1073799623
Name:CONTRERAS, LEONEL (CAS II)
Entity Type:Individual
Prefix:
First Name:LEONEL
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:CAS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83844 HOPI AVE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-2638
Mailing Address - Country:US
Mailing Address - Phone:760-347-9442
Mailing Address - Fax:
Practice Address - Street 1:43485 HOLLYHOCK
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-2638
Practice Address - Country:US
Practice Address - Phone:760-347-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01-970566101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor