Provider Demographics
NPI:1083069140
Name:SANCHEZ, LESLIE FARIAS (LMFT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:FARIAS
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 THIRD AVE STE C23
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3955
Mailing Address - Country:US
Mailing Address - Phone:619-728-9330
Mailing Address - Fax:
Practice Address - Street 1:310 THIRD AVE STE C23
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3955
Practice Address - Country:US
Practice Address - Phone:619-728-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109362101YM0800X
101Y00000X
CA121273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor